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Diabetes Care

Matthew W Segar, Muthiah Vaduganathan, Kershaw V Patel, Darren K McGuire, Javed Butler, Gregg C Fonarow, Mujeeb Basit, Vaishnavi Kannan, Justin L Grodin, Brendan Everett, Duwayne Willett, Jarett Berry, Ambarish Pandey
OBJECTIVE: To develop and validate a novel, machine learning-derived model to predict the risk of heart failure (HF) among patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: Using data from 8,756 patients free at baseline of HF, with <10% missing data, and enrolled in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, we used random survival forest (RSF) methods, a nonparametric decision tree machine learning approach, to identify predictors of incident HF...
September 13, 2019: Diabetes Care
Sridharan Raghavan, Yuk-Lam Ho, Vinay Kini, Mary K Rhee, Jason L Vassy, David R Gagnon, Kelly Cho, Peter W F Wilson, Lawrence S Phillips
OBJECTIVE: Guidelines for hypertension treatment in patients with diabetes diverge regarding the systolic blood pressure (SBP) threshold at which treatment should be initiated and treatment goal. We examined associations of early SBP treatment with atherosclerotic cardiovascular disease (ASCVD) events in U.S. adults with diabetes. RESEARCH DESIGN AND METHODS: We studied 43,986 patients with diabetes who newly initiated antihypertensive therapy between 2002 and 2007...
September 12, 2019: Diabetes Care
Satyesh K Sinha, Susanne B Nicholas, Jung Hye Sung, Adolfo Correa, Tripathi B Rajavashisth, Keith C Norris, Jae Eun Lee
OBJECTIVE: African Americans (AA) suffer disproportionately from diabetic nephropathy (DN). C-reactive protein (CRP) has been associated with prevalent DN, but its association with incident DN in AA is unknown. We examined hs-CRP and incident DN in AA. RESEARCH DESIGN AND METHODS: We conducted a longitudinal analysis of data from exams 1, 2, and 3 in 4,043 eligible Jackson Heart Study participants. Participants with DN or without hs-CRP at exam 1 were excluded. Incident DN was defined as urinary albumin-to-creatinine ratio (ACR) >30 mg/g or self-reported dialysis/transplantation and type 2 diabetes mellitus (DM) or HbA1c >6...
September 11, 2019: Diabetes Care
Amy S Shah, Laure El Ghormli, Mary Ellen Vajravelu, Fida Bacha, Ryan M Farrell, Samuel S Gidding, Lorraine E Levitt Katz, Jeanie B Tryggestad, Neil H White, Elaine M Urbina
OBJECTIVE: To determine whether prior type 2 diabetes (T2D) treatment or glycemic control over time are independently associated with heart rate variability (HRV) and whether the presence of cardiac autonomic dysfunction is associated with arterial stiffness in young adults with youth-onset T2D enrolled in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. RESEARCH DESIGN AND METHODS: Heartbeats over 10 min were measured to derive the normal R-Rs (NN intervals)...
September 9, 2019: Diabetes Care
Stanley M H Yeung, S Heleen Binnenmars, Christina M Gant, Gerjan Navis, Ron T Gansevoort, Stephan J L Bakker, Martin H de Borst, Gozewijn D Laverman
OBJECTIVE: To study whether fibroblast growth factor 23 (FGF23) is associated with adverse outcomes in patients with type 2 diabetes and normal or mildly impaired kidney function. RESEARCH DESIGN AND METHODS: We analyzed COOH-terminal FGF23 levels in 310 patients with type 2 diabetes and estimated glomerular filtration rate ≥60 mL/min/1.73 m2 . Associations of FGF23 with all-cause mortality and major adverse cardiovascular events (MACE) were studied by Cox regression...
September 5, 2019: Diabetes Care
Louisa van den Boom, Beate Karges, Marie Auzanneau, Birgit Rami-Merhar, Eggert Lilienthal, Simone von Sengbusch, Nicolin Datz, Carmen Schröder, Thomas Kapellen, Markus Laimer, Sebastian M Schmid, Heiko Müller, Johannes Wolf, Reinhard W Holl
OBJECTIVE: To investigate temporal trends and contemporary use of insulin pump therapy and glucose monitoring in type 1 diabetes. RESEARCH DESIGN AND METHODS: In a population-based study, we analyzed the use of insulin pump therapy, continuous glucose monitoring (CGM), and self-monitoring of blood glucose (SMBG) from 1995 to 2017 in patients with type 1 diabetes identified from the Diabetes Prospective Follow-up database in Germany and Austria. Patients were stratified by age, sex, migration background, and country...
September 5, 2019: Diabetes Care
Anneliese J S Flatt, Stuart A Little, Jane Speight, Lalantha Leelarathna, Emma Walkinshaw, Horng Kai Tan, Anita Bowes, Alexandra Lubina-Solomon, Elizabeth Holmes-Truscott, Thomas J Chadwick, Ruth Wood, Timothy J McDonald, David Kerr, Daniel Flanagan, Augustin Brooks, Simon R Heller, Mark L Evans, James A M Shaw
OBJECTIVE: The HypoCOMPaSS study was designed to test the hypothesis that successful avoidance of biochemical hypoglycemia without compromising overall glycemic control would restore sufficient hypoglycemia awareness to prevent recurrent severe hypoglycemia in the majority of participants with established type 1 diabetes. Before starting the study, we planned to investigate associations between baseline characteristics and recurrent severe hypoglycemia over 2 years' follow-up. RESEARCH DESIGN AND METHODS: A total of 96 adults with type 1 diabetes and impaired awareness of hypoglycemia participated in a 24-week 2 × 2 factorial randomized controlled trial comparing insulin delivery and glucose monitoring modalities, with the goal of rigorous biochemical hypoglycemia avoidance...
September 4, 2019: Diabetes Care
Thomas Nyström, Stefan K James, Bertil Lindahl, Ollie Östlund, David Erlinge, Johan Herlitz, Elmir Omerovic, Linda Mellbin, Joakim Alfredsson, Ole Fröbert, Tomas Jernberg, Robin Hofmann
OBJECTIVE: To determine the effects of oxygen therapy in myocardial infarction (MI) patients with and without diabetes. RESEARCH DESIGN AND METHODS: In the Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6-12 h or ambient air. In this prespecified analysis involving 5,010 patients with confirmed MI, 934 had known diabetes. Oxidative stress may be of particular importance in diabetes, and the primary objective was to study the effect of supplemental oxygen on the composite of all-cause death and rehospitalization with MI or heart failure (HF) at 1 year in patients with and without diabetes...
August 31, 2019: Diabetes Care
Caroline A Jackson, Kelly Fleetwood, Jan Kerssens, Daniel J Smith, Stewart Mercer, Sarah H Wild
OBJECTIVE: To determine the incidence of type 2 diabetes in people with a history of hospitalization for major mental illness versus no mental illness in Scotland by time period and sociodemographics. RESEARCH DESIGN AND METHODS: We used national Scottish population-based records to create cohorts with a hospital record of schizophrenia, bipolar disorder, or depression or no mental illness and to ascertain diabetes incidence. We used quasi-Poisson regression models including age, sex, time period, and area-based deprivation to estimate incidence and relative risks (RRs) of diabetes by mental illness status...
August 30, 2019: Diabetes Care
Sanyog G Shitole, Mary L Biggs, Alexander P Reiner, Kenneth J Mukamal, Luc Djoussé, Joachim H Ix, Joshua I Barzilay, Russell P Tracy, David Siscovick, Jorge R Kizer
OBJECTIVE: Experimental studies have implicated soluble (s)CD14, an effector of lipopolysaccharide-induced inflammation, in insulin resistance, but its role in human metabolic endotoxemia has not been studied. We evaluated sCD14 in relation to dysglycemia in older adults and how this compares to other markers of inflammation. RESEARCH DESIGN AND METHODS: We investigated associations of sCD14, interleukin-6 (IL-6), CRP, and white blood cell (WBC) count with insulin resistance (quantitative insulin-sensitivity check index and HOMA 2 of insulin resistance) and incident type 2 diabetes in a population-based cohort of older adults...
August 30, 2019: Diabetes Care
Tiansheng Wang, Jeff Y Yang, John B Buse, Virginia Pate, Huilin Tang, Edward L Barnes, Robert S Sandler, Til Stürmer
OBJECTIVE: A recent study raises concerns that dipeptidyl peptidase 4 inhibitors (DPP4i) are associated with increased risk of inflammatory bowel disease (IBD). We evaluated the association between new use of DPP4i and IBD risk compared with other second-line antihyperglycemics. RESEARCH DESIGN AND METHODS: We implemented an active-comparator, new-user cohort design using two U.S. administrative claims databases for commercially insured (MarketScan) and older adults (Medicare fee-for-service, 20% random sample) patients from January 2007 to December 2016...
August 30, 2019: Diabetes Care
Munachiso Nwokolo, Stephanie A Amiel, Owen O'Daly, Megan L Byrne, Bula M Wilson, Andrew Pernet, Sally M Cordon, Ian A Macdonald, Fernando O Zelaya, Pratik Choudhary
OBJECTIVE: Impaired awareness of hypoglycemia (IAH) affects one-quarter of adults with type 1 diabetes and significantly increases the risk of severe hypoglycemia. Differences in regional brain responses to hypoglycemia may contribute to the susceptibility of this group to problematic hypoglycemia. This study investigated brain responses to hypoglycemia in IAH and hypoglycemia aware (HA) adults with type 1 diabetes, using three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) MRI to measure changes in regional cerebral blood flow (CBF)...
August 27, 2019: Diabetes Care
Kirstine J Bell, Chantelle Z Fio, Stephen Twigg, Sally-Anne Duke, Gregory Fulcher, Kylie Alexander, Margaret McGill, Jencia Wong, Jennie Brand-Miller, Garry M Steil
OBJECTIVE: The American Diabetes Association recommends individuals with type 1 diabetes (T1D) adjust insulin for dietary fat; however, optimal adjustments are not known. This study aimed to determine: 1 ) the relationship between the amount and type of dietary fat and glycemia and 2 ) the optimal insulin adjustments for dietary fat. RESEARCH DESIGN AND METHODS: Adults with T1D using insulin pump therapy attended the research clinic on 9-12 occasions. On the first six visits, participants consumed meals containing 45 g carbohydrate with 0 g, 20 g, 40 g, or 60 g fat and saturated, monounsaturated, or polyunsaturated fat...
August 27, 2019: Diabetes Care
Jieli Lu, Sin Man Lam, Qin Wan, Lixin Shi, Yanan Huo, Lulu Chen, Xulei Tang, Bowen Li, Xueyan Wu, Kui Peng, Mian Li, Shuangyuan Wang, Yu Xu, Min Xu, Yufang Bi, Guang Ning, Guanghou Shui, Weiqing Wang
OBJECTIVE: Comprehensive assessment of serum lipidomic aberrations before type 2 diabetes (T2DM) onset has remained lacking in Han Chinese. We evaluated changes in lipid coregulation antecedent to T2DM and identified novel lipid predictors for T2DM in individuals with normal glucose regulation (NGR). RESEARCH DESIGN AND METHODS: In the discovery study, we tested 667 baseline serum lipids in subjects with incident diabetes and propensity score-matched control subjects ( n = 200) from a prospective cohort comprising 3,821 Chinese adults with NGR...
August 27, 2019: Diabetes Care
Gloria A Aguayo, Adam Hulman, Michel T Vaillant, Anne-Françoise Donneau, Anna Schritz, Saverio Stranges, Laurent Malisoux, Laetitia Huiart, Michèle Guillaume, Séverine Sabia, Daniel R Witte
OBJECTIVE: Frailty is a dynamic state of vulnerability in the elderly. We examined whether individuals with overt diabetes or higher levels of HbA1c or fasting plasma glucose (FG) experience different frailty trajectories with aging. RESEARCH DESIGN AND METHODS: Diabetes, HbA1c , and FG were assessed at baseline, and frailty status was evaluated with a 36-item frailty index every 2 years during a 10-year follow-up among participants from the English Longitudinal Study of Ageing...
August 26, 2019: Diabetes Care
Alexandre Jehl, Christine Cugnet-Anceau, Corinne Vigouroux, Anne L Legeay, Stéphane Dalle, Olivier Harou, Lucien Marchand, Olivier Lascols, Cyrielle Caussy, Charles Thivolet, Martine Laville, Emmanuel Disse
OBJECTIVE: Anti-programmed cell death-1 (anti-PD-1) antibodies have revolutionized advanced cancer therapy. Anti-PD-1 therapy is responsible for immune-related adverse events, with frequent endocrine manifestations, including acute-onset type 1 diabetes. Acquired generalized lipodystrophy (AGL) is a rare disease, believed to be immune mediated, characterized by loss of adipose tissue and insulin resistance-associated complications. RESEARCH DESIGN AND METHODS: We describe the first reported case of AGL induced by immune checkpoint therapy...
August 21, 2019: Diabetes Care
Justin B Echouffo-Tcheugui, Stanford E Mwasongwe, Mario Sims, Samuel Dagogo-Jack, Sherita H Golden, Adolfo Correa, Solomon K Musani
No abstract text is available yet for this article.
August 20, 2019: Diabetes Care
Minyoung Lee, Jiyu Sun, Minkyung Han, Yongin Cho, Ji-Yeon Lee, Chung Mo Nam, Eun Seok Kang
OBJECTIVE: Dipeptidyl peptidase-4 inhibitors (DPP-4i) are useful incretin-based antidiabetes drugs. However, there is a concern that DPP-4i may adversely impact the exocrine pancreas, owing to their pleiotropic effects. In this study, we investigated whether DPP-4i are associated with pancreatitis and pancreatic cancer using a nationwide population-based cohort study. RESEARCH DESIGN AND METHODS: We included patients newly diagnosed with type 2 diabetes who were treated with antidiabetes drugs ( n = 33,208) from 2007 to 2013...
August 20, 2019: Diabetes Care
Michaël J B van Baar, Charlotte C van Ruiten, Marcel H A Muskiet, Liselotte van Bloemendaal, Richard G IJzerman, Daniël H van Raalte
No abstract text is available yet for this article.
August 20, 2019: Diabetes Care
Katherine A Pratte, Ann Johnson, Janette Beals, Ann Bullock, Spero M Manson, Luohua Jiang
No abstract text is available yet for this article.
August 20, 2019: Diabetes Care
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