Diabetes Care

Annelie Carlsson, Maggie Shepherd, Sian Ellard, Michael Weedon, Åke Lernmark, Gun Forsander, Kevin Colclough, Qefsere Brahimi, Camilla Valtonen-Andre, Sten A Ivarsson, Helena Elding Larsson, Ulf Samuelsson, Eva Örtqvist, Leif Groop, Johnny Ludvigsson, Claude Marcus, Andrew T Hattersley
OBJECTIVE: Identifying maturity-onset diabetes of the young (MODY) in pediatric populations close to diabetes diagnosis is difficult. Misdiagnosis and unnecessary insulin treatment are common. We aimed to identify the discriminatory clinical features at diabetes diagnosis of patients with glucokinase (GCK), hepatocyte nuclear factor-1A (HNF1A), and HNF4A MODY in the pediatric population. RESEARCH DESIGN AND METHODS: Swedish patients ( n = 3,933) aged 1-18 years, diagnosed with diabetes May 2005 to December 2010 were recruited from the national consecutive prospective cohort Better Diabetes Diagnosis...
November 8, 2019: Diabetes Care
Francisco J Pasquel, Katerina Tsegka, Heqiong Wang, Saumeth Cardona, Rodolfo J Galindo, Maya Fayfman, Georgia Davis, Priyathama Vellanki, Alexandra Migdal, Unjali Gujral, K M Venkat Narayan, Guillermo E Umpierrez
OBJECTIVE: Many patients with hyperglycemic crises present with combined features of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). The implications of concomitant acidosis and hyperosmolality are not well known. We investigated hospital outcomes in patients with isolated or combined hyperglycemic crises. RESEARCH DESIGN AND METHODS: We analyzed admissions data listing DKA or HHS at two academic hospitals. We determined 1 ) the frequency distributions of HHS, DKA, and combined DKA-HHS (DKA criteria plus elevated effective osmolality); 2 ) the relationship between markers of severity of illness and clinical comorbidities on 30-day all-cause mortality; and 3 ) the relationship of hospital complications associated with insulin therapy (hypoglycemia and hypokalemia) on mortality...
November 8, 2019: Diabetes Care
Jeremy H Pettus, David D'Alessio, Juan P Frias, Eric G Vajda, James D Pipkin, Julio Rosenstock, Gretchen Williamson, Miriam A Zangmeister, Lin Zhi, Keith B Marschke
OBJECTIVE: Evaluate the safety and efficacy of RVT-1502, a novel oral glucagon receptor antagonist, in subjects with type 2 diabetes inadequately controlled on metformin. RESEARCH DESIGN AND METHODS: In a phase 2, double-blind, randomized, placebo-controlled study, subjects with type 2 diabetes ( n = 166) on a stable dose of metformin were randomized (1:1:1:1) to placebo or RVT-1502 5, 10, or 15 mg once daily for 12 weeks. The primary end point was change from baseline in HbA1c for each dose of RVT-1502 compared with placebo...
November 6, 2019: Diabetes Care
Sandra L Neoh, Jennifer M Yamamoto, Denice S Feig, Helen R Murphy
No abstract text is available yet for this article.
November 6, 2019: Diabetes Care
Cole D Bendor, Aya Bardugo, Inbar Zucker, Tali Cukierman-Yaffe, Miri Lutski, Estela Derazne, Tammy Shohat, Ofri Mosenzon, Dorit Tzur, Ari Sapir, Orit Pinhas-Hamiel, Richard G Kibbey, Itamar Raz, Arnon Afek, Hertzel C Gerstein, Amir Tirosh, Gilad Twig
OBJECTIVE: The relationship between acute pancreatitis and incident diabetes is unclear. We assessed whether a resolved single event of acute pancreatitis in childhood was associated with incident diabetes in adulthood. RESEARCH DESIGN AND METHODS: A nationwide, population-based study of 1,802,110 Israeli adolescents (mean age 17.4 years [range, 16-20]) who were examined before compulsory military service between 1979 and 2008 and whose data were linked to the Israeli National Diabetes Registry...
November 6, 2019: Diabetes Care
Robyn A Barnes, Tang Wong, Glynis P Ross, Michelle M Griffiths, Carmel E Smart, Clare E Collins, Lesley MacDonald-Wicks, Jeff R Flack
OBJECTIVE: Conventional gestational diabetes mellitus (GDM) management focuses on managing blood glucose in order to prevent adverse outcomes. We hypothesized that excessive weight gain at first presentation with GDM (excessive gestational weight gain [EGWG]) and continued EGWG (cEGWG) after commencing GDM management would increase the risk of adverse outcomes, despite treatment to optimize glycemia. RESEARCH DESIGN AND METHODS: Data collected prospectively from pregnant women with GDM at a single institution were analyzed...
November 5, 2019: Diabetes Care
Petter Bjornstad, Kara Hughan, Megan M Kelsey, Amy S Shah, Jane Lynch, Edward Nehus, Mark Mitsnefes, Todd Jenkins, Peixin Xu, Changchun Xie, Thomas Inge, Kristen Nadeau
OBJECTIVE: To compare diabetic kidney disease (DKD) rates over 5 years of follow-up in two cohorts of severely obese adolescents with type 2 diabetes (T2D) undergoing medical or surgical treatment for T2D. RESEARCH DESIGN AND METHODS: A secondary analysis was performed of data collected from obese participants of similar age and racial distribution enrolled in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) and the Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) studies...
November 4, 2019: Diabetes Care
Kellee M Miller, Julia Hermann, Nicole Foster, Sabine E Hofer, Michael R Rickels, Thomas Danne, Mark A Clements, Eggert Lilienthal, David M Maahs, Reinhard W Holl
No abstract text is available yet for this article.
October 31, 2019: Diabetes Care
Erik J M van Bommel, Danique Ruiter, Marcel H A Muskiet, Michaël J B van Baar, Mark H H Kramer, Max Nieuwdorp, Jaap A Joles, Petter Bjornstad, Daniël H van Raalte
OBJECTIVE: Impaired insulin sensitivity is associated with hyperfiltration (i.e., elevated glomerular filtration rate [GFR]) in adolescents with type 2 diabetes (T2D) and adults with prediabetes. Yet, these relationships are based on studies that relied on estimated GFR (eGFR), estimates of insulin sensitivity, or both. We aimed to verify the relationship between insulin sensitivity and renal hemodynamic function by gold standard methods in adults with T2D. RESEARCH DESIGN AND METHODS: Insulin sensitivity was assessed by hyperinsulinemic-euglycemic clamp (M value) (glucose infusion rate in mg/kglean /min) and renal hemodynamic function by urinary inulin (GFR) and para-aminohippuric acid (effective renal plasma flow [ERPF]) clearances in participants with T2D without overt kidney disease...
October 29, 2019: Diabetes Care
Fjorda Koromani, Ling Oei, Enisa Shevroja, Katerina Trajanoska, Josje Schoufour, Taulant Muka, Oscar H Franco, M Arfan Ikram, M Carola Zillikens, André G Uitterlinden, Gabriel P Krestin, Tassos Anastassiades, Robert Josse, Stephanie M Kaiser, David Goltzman, Brian C Lentle, Jerilynn C Prior, William D Leslie, Eugene McCloskey, Olivier Lamy, Didier Hans, Edwin H Oei, Fernando Rivadeneira
OBJECTIVE: We aimed to assess whether individuals with type 2 diabetes (T2D) have increased risk of vertebral fractures (VFs) and to estimate nonvertebral fracture and mortality risk among individuals with both prevalent T2D and VFs. RESEARCH DESIGN AND METHODS: A systematic PubMed search was performed to identify studies that investigated the relationship between T2D and VFs. Cohorts providing individual-participant data (IPD) were also included. Estimates from published summary data and IPD cohorts were pooled in a random-effects meta-analysis...
October 28, 2019: Diabetes Care
Simon R Heller, John B Buse, Robert Ratner, Elizabeth Seaquist, Lars Bardtrum, Charlotte Thim Hansen, Deniz Tutkunkardas, Alan C Moses
OBJECTIVE: The purpose of this study was to determine if the International Hypoglycemia Study Group (IHSG) level 2 low glucose definition could identify clinically relevant hypoglycemia in clinical trials and offer value as an end point for future trials. RESEARCH DESIGN AND METHODS: A post hoc analysis of the SWITCH (SWITCH 1: n = 501, type 1 diabetes; SWITCH 2: n = 721, type 2 diabetes) and the Trial Comparing Cardiovascular Safety of Insulin Degludec versus Insulin Glargine in Patients with Type 2 Diabetes at High Risk of Cardiovascular Events (DEVOTE; n = 7,637, type 2 diabetes) using the IHSG low glucose definitions...
October 28, 2019: Diabetes Care
Zobair M Younossi, Radhika P Tampi, Andrei Racila, Ying Qiu, Leah Burns, Issah Younossi, Fatema Nader
OBJECTIVE: Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD) and is strongly associated with type 2 diabetes mellitus (T2DM). Patients with both T2DM and NASH have increased risk for adverse clinical outcomes, leading to higher risk for mortality and morbidity. We built a Markov model with 1-year cycles and 20-year horizon to estimate the economic burden of NASH with T2DM in the U.S. RESEARCH DESIGN AND METHODS: Cohort size was determined by population size, prevalence of T2DM, and prevalence and incidence of NASH in 2017...
October 28, 2019: Diabetes Care
Ben Schöttker, Yang Xuan, Xīn Gào, Ankita Anusruti, Hermann Brenner
OBJECTIVE: Oxidative stress is believed to play an important role in the pathophysiology of type 2 diabetes, but the few cohort studies that have assessed the association of oxidative stress biomarkers with type 2 diabetes incidence were small and reported inconclusive results. RESEARCH DESIGN AND METHODS: We examined the associations of urinary oxidized guanine/guanosine (OxGua) levels (a biomarker of DNA/RNA oxidation) and urinary 8-isoprostane levels (a biomarker of lipid peroxidation) with type 2 diabetes incidence in 7,828 individuals initially without diabetes from a population-based German cohort study with 14 years of follow-up...
October 25, 2019: Diabetes Care
Jusung Lee, Timothy Callaghan, Marcia Ory, Hongwei Zhao, Jane N Bolin
OBJECTIVE: Diabetes is a chronic health condition contributing to a substantial burden of disease. According to the Robert Wood Johnson Foundation, 10.9 million people were newly insured by Medicaid between 2013 and 2016. Considering this coverage expansion, the Affordable Care Act (ACA) could significantly affect persons with diabetes in their management of the disease. This study evaluates the impact of the Medicaid expansion under the ACA on diabetes management. RESEARCH DESIGN AND METHODS: This study includes 22,335 individuals with diagnosed diabetes from the 2011 to 2016 Behavioral Risk Factor Surveillance System...
October 24, 2019: Diabetes Care
M Juhani Junttila, Ari Pelli, Tuomas V Kenttä, Tim Friede, Rik Willems, Leonard Bergau, Marek Malik, Bert Vandenberk, Marc A Vos, Georg Schmidt, Bela Merkely, Andrzej Lubinski, Martin Svetlosak, Frieder Braunschweig, Markus Harden, Markus Zabel, Heikki V Huikuri, Christian Sticherling
OBJECTIVE: Diabetes increases the risk of all-cause mortality and sudden cardiac death (SCD). The exact mechanisms leading to sudden death in diabetes are not well known. We compared the incidence of appropriate shocks and mortality in patients with versus without diabetes with a prophylactic implantable cardioverter defibrillator (ICD) included in the retrospective EU-CERT-ICD registry. RESEARCH DESIGN AND METHODS AND RESULTS: A total of 3,535 patients from 12 European EU-CERT-ICD centers with a mean age of 63...
October 23, 2019: Diabetes Care
Elsa Heyman, Frédéric Daussin, Valerie Wieczorek, Robert Caiazzo, Régis Matran, Phanélie Berthon, Julien Aucouturier, Serge Berthoin, Aurélien Descatoire, Erwan Leclair, Gaëlle Marais, Adrien Combes, Pierre Fontaine, Sémah Tagougui
OBJECTIVE: Long before clinical complications of type 1 diabetes (T1D) develop, oxygen supply and use can be altered during activities of daily life. We examined in patients with uncomplicated T1D all steps of the oxygen pathway, from the lungs to the mitochondria, using an integrative ex vivo (muscle biopsies) and in vivo (during exercise) approach. RESEARCH DESIGN AND METHODS: We compared 16 adults with T1D with 16 strictly matched healthy controls. We assessed lung diffusion capacity for carbon monoxide and nitric oxide, exercise-induced changes in arterial O2 content (SaO2 , PaO2 , hemoglobin), muscle blood volume, and O2 extraction (via near-infrared spectroscopy)...
October 21, 2019: Diabetes Care
Gregory L Kinney, Halis K Akturk, Daniel D Taylor, Nicole C Foster, Viral N Shah
OBJECTIVE: We examined the frequency of diabetic ketoacidosis (DKA) in cannabis users compared with nonusers in the T1D Exchange clinic registry (T1DX). RESEARCH DESIGN AND METHODS: The association between cannabis use by total substance score for cannabis (TSC) and DKA in the past 12 months was examined using a logistic regression model adjusted for potential confounders among adults in the T1DX. RESULTS: Of 932 adults with type 1 diabetes, 61 had a TSC >4, which classified them as moderate cannabis users...
October 18, 2019: Diabetes Care
Claudia R L Cardoso, Nathalie C Leite, Giovanna Bacan, Dayane S Ataíde, Larissa K C Gorgonio, Gil F Salles
OBJECTIVE: To evaluate the prognostic importance of resistant hypertension (RHT) for the development of complications in a cohort of individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: 646 patients had the diagnosis of apparent treatment-resistant hypertension (aRHT) based on mean office blood pressure (BP) levels during the 1st year of follow-up. They were reclassified as white-coat/controlled or true/uncontrolled RHT according to 24-h ambulatory BP monitoring (ABPM), using the traditional BP cutoffs and the new 2017 American College of Cardiology (ACC)/American Heart Association (AHA) criteria...
October 16, 2019: Diabetes Care
Robert G Frykberg, Peter J Franks, Michael Edmonds, Jonathan N Brantley, Luc Téot, Thomas Wild, Matthew G Garoufalis, Aliza M Lee, Janette A Thompson, Gérard Reach, Cyaandi R Dove, Karim Lachgar, Dirk Grotemeyer, Sophie C Renton
OBJECTIVE: Topical oxygen has been used for the treatment of chronic wounds for more than 50 years. Its effectiveness remains disputed due to the limited number of robust high-quality investigations. The aim of this study was to assess the efficacy of multimodality cyclical pressure Topical Wound Oxygen (TWO2) home care therapy in healing refractory diabetic foot ulcers (DFUs) that had failed to heal with standard of care (SOC) alone. RESEARCH DESIGN AND METHODS: Patients with diabetes and chronic DFUs were randomized (double-blind) to either active TWO2 therapy or sham control therapy-both in addition to optimal SOC...
October 16, 2019: Diabetes Care
Jessica L Harding, Stephen R Benoit, Edward W Gregg, Meda E Pavkov, Leigh Perreault
OBJECTIVE: Vascular complications of diabetes have declined substantially over the past 20 years. However, the impact of modern medical treatments on infectious diseases in people with diabetes remains unknown. RESEARCH DESIGN AND METHODS: We estimated rates of infections requiring hospitalizations in adults (≥18 years) with versus without diabetes, using the 2000-2015 National Inpatient Sample and the National Health Interview Surveys. Annual age-standardized and age-specific hospitalization rates in groups with and without diabetes were stratified by infection type...
October 15, 2019: Diabetes Care
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