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Diabetes, Obesity & Metabolism

Masaya Koshizaka, Ko Ishikawa, Ryoichi Ishibashi, Yoshiro Maezawa, Kenichi Sakamoto, Daigaku Uchida, Susumu Nakamura, Masaya Yamaga, Hidetaka Yokoh, Akina Kobayashi, Shunichiro Onishi, Kazuki Kobayashi, Jun Ogino, Naotake Hashimoto, Hirotake Tokuyama, Fumio Shimada, Emi Ohara, Takahiro Ishikawa, Mayumi Shoji, Shintaro Ide, Kana Ide, Yusuke Baba, Akiko Hattori, Takumi Kitamoto, Takuro Horikoshi, Ryouta Shimofusa, Sho Takahashi, Kengo Nagashima, Yasunori Sato, Minoru Takemoto, L Kristin Newby, Koutaro Yokote
A prospective, multicentre, open-label, blinded-endpoint, randomised controlled study was conducted to evaluate the efficacy of treatment with ipragliflozin (sodium-dependent glucose transporter-2 inhibitor) versus metformin for visceral fat reduction and glycaemic control among Japanese patients with type 2 diabetes treated with sitagliptin, HbA1c levels of 7-10%, and BMI ≥22 kg/m2 . Patients were randomly assigned (1:1) to receive ipragliflozin 50 mg or metformin 1000-1500 mg daily. The primary outcome was change in visceral fat area as measured by computed tomography after 24 weeks of therapy...
April 17, 2019: Diabetes, Obesity & Metabolism
Jeremy Pettus, Jasvinder Gill, Sachin Paranjape, John Stewart, Shilpy Malla, Steven Edelman, Richard M Bergenstal, Bruce Bode
AIMS: This multicentre (N = 104), randomized controlled phase 4 study compared the efficacy and safety of insulin glargine 300 units/mL (Gla-300) with insulin glargine 100 units/mL (Gla-100) in patients with type 1 diabetes (T1D) ( identifier: NCT02688933). MATERIALS AND METHODS: Patients were randomized 1:1 to self-perform morning Gla-300 or Gla-100 injections daily for 16 weeks. The primary endpoint was the percentage of time blood glucose remained in the target range (70-180 mg/dL) during Week 15/16, measured by blinded continuous glucose monitoring...
April 17, 2019: Diabetes, Obesity & Metabolism
Jin Xia, Yiqing Song, Shristi Rawal, Jing Wu, Stefanie N Hinkle, Michael Y Tsai, Cuilin Zhang
AIMS: Emerging evidence suggests that maternal vitamin D status may be associated with gestational diabetes (GDM). However, the temporal relation remains unclear due to the lack of longitudinal data on vitamin D over pregnancy. We aimed to prospectively and longitudinally investigate vitamin D status during early to mid-pregnancy in relation to GDM risk. METHODS: In a nested case-control study of 107 GDM cases and 214 controls within the Fetal Growth Studies-Singleton Cohort, plasma levels of 25-hydroxyvitamin D2 and D3 (25(OH)D) and vitamin D binding protein were measured at gestational weeks 10-14, 15-26, 23-31, and 33-39; we further calculated total, free, and bioavailable 25(OH)D...
April 17, 2019: Diabetes, Obesity & Metabolism
Gian Paolo Fadini, Veronica Sciannameo, Ivano Franzetti, Daniele Bottigliengo, Paola D'Angelo, Carmela Vinci, Paola Berchialla, Salvatore Arena, Raffaella Buzzetti, Angelo Avogaro
BACKGROUND AND AIMS: Based on cardiovascular outcome trials, some sodium-glucose contransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) are recommended for secondary cardiovascular prevention in type 2 diabetes (T2D). In this real-world study, we compared the simultaneous reductions in HbA1c, body weight, and systolic blood pressure after initiation of dapagliflozin or GLP-1RA as second or more advanced line of therapy. METHODS: DARWIN-T2D was a retrospective multi-centre study conducted at diabetes specialist clinics in Italy...
April 15, 2019: Diabetes, Obesity & Metabolism
Ilaria Dicembrini, Besmir Nreu, Edoardo Mannucci, Matteo Monami
BACKGROUND: Concerns on the effect of SGLT-2 inhibitors (SGLT-2i) have been risen by some studies, showing an increased incidence of bladder cancer, particularly for empagliflozin. Aim of the present meta-analysis of randomized trials is the assessment of the effects of SGLT-2i on overall incidence of malignancies and on different cancer types, synthetizing the results of trials with a duration of at least one year. METHODS: A Medline and Embase search for "Canaglifozin", "Dapaglifozin", "Empaglifozin", "Ertuglifozin", "Ipraglifozin", Tofoglifozin", or "Luseoglifozin" was performed, collecting randomized trials (duration>52 weeks) up to December 1st , 2018, comparing SGLT-2i with placebo or active comparators...
April 11, 2019: Diabetes, Obesity & Metabolism
Shih-Chang Lo, Edy Kornelius, Jing-Yang Huang, Yung-Rung Lai, Chien-Ning Huang, Yi-Sun Yang, Jeng-Yuan Chiou
OBJECTIVE: Severe hypoglycaemia is associated with a high risk of cardiovascular events in patient with diabetes. The aim of this study is to clarify the temporal relationship between hypoglycaemia and cardiovascular events. RESEARCH DESIGN AND METHODS: This observational cohort study was conducted using Taiwan's Longitudinal Cohort of Diabetes Patients Database, which included 360,000 patients with newly diagnosed diabetes for the period 1999 to 2001. Patients with the first severe hypoglycaemia after 2002 served as the study cohort...
April 11, 2019: Diabetes, Obesity & Metabolism
Martin Adiels, Marja-Riitta Taskinen, Elias Björnson, Linda Andersson, Niina Matikainen, Sanni Söderlund, Juhani Kahri, Antti Hakkarainen, Nina Lundbom, Carina Sihlbom, Annika Thorsell, Haihong Zhou, Kirsi H Pietiläinen, Chris Packard, Jan Borén
AIMS: ApoC-III is an important novel target underpinning the link between hypertriglyceridemia with cardiovascular disease. Here, we investigated how apoC-III metabolism is altered in subjects with type 2 diabetes, and focused on whether the perturbed plasma triglyceride concentrations in this condition are determined primarily by the secretion rate or the removal rate of this apoprotein. Second, we investigated whether improvement of glycemic control using the GLP-1 analogue liraglutide for 16 weeks modifies apoC-III dynamics...
April 10, 2019: Diabetes, Obesity & Metabolism
Dario Giugliano, Luca De Nicola, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
Diabetic kidney disease (DKD) still remains a progressive condition that is associated with higher risk of end-stage kidney disease and significant cardiovascular morbidity and mortality. Twelve cardiovascular outcome trials (CVOTs) in type 2 diabetes (T2D) have been so far published. Most trials with dipeptidyl-peptidase inhibitors (SAVOR-TIMI 53 with saxagliptin, EXAMINE with alogliptin, TECOS with sitagliptin, and CARMELINA with linagliptin), and with the glucagon-like peptide-1 receptor agonists (GLP-1 RAs) (ELIXA with lixisenatide, LEADER with liraglutide, SUSTAIN-6 with semaglutide, EXCSEL with exenatide once weekly, and HARMONY with albiglutide) pointed toward reduced albuminuria which is a surrogate endpoint possibly heralding renal function preservation...
April 10, 2019: Diabetes, Obesity & Metabolism
Eric Wittbrodt, David Chamberlain, Suzanne V Arnold, Fengming Tang, Mikhail Kosiborod
Generalizability of findings from cardiovascular outcomes trials (CVOTs) to patients with type 2 diabetes (T2D) in clinical practice is unknown. We assessed the proportions of patients in the Diabetes Collaborative Registry who would have met enrollment criteria for pivotal CVOTs of sodium-glucose cotransporter-2 inhibitors (SGLT-2is): EMPA-REG OUTCOME, CANVAS, DECLARE and VERTIS CV. In 172,643 patients, mean (standard deviation [SD]) age and glycated hemoglobin were 68.1 (11.8) years and 7.8% (2.2), respectively; 56...
April 10, 2019: Diabetes, Obesity & Metabolism
Anna Ferrulli, Concetta Macrì, Ileana Terruzzi, Stefano Massarini, Federico Ambrogi, Michela Adamo, Valentina Milani, Livio Luzi
No abstract text is available yet for this article.
April 8, 2019: Diabetes, Obesity & Metabolism
Christopher Hupfeld, Sunder Mudaliar
The publication of the recent CVOTs (Cardio Vascular Outcome Trials) has transformed the landscape of diabetes treatment. The GLP-1R agonists (GLP-1R agonists) and the SGLT2-Inhibitors have demonstrated CV benefits in large, well conducted, randomized studies. Today, empagliflozin, canagliflozin and liraglutide are FDA approved not only for glucose lowering, but also to reduce the risk of CV events/CV mortality in patients with type 2 diabetes (T2DM) and established CV Disease (CVD)/high CVD risk. Although the CVOTs were primarily powered for CV safety (non-inferiority), they also demonstrated CV efficacy (superiority)...
April 8, 2019: Diabetes, Obesity & Metabolism
Donnie Funch, Kathleen Mortimer, Najat J Ziyadeh, John D Seeger, Ling Li, Heather Norman, Atheline Major-Pedersen, Heidrun Bosch-Traberg, Helge Gydesen, David D Dore
AIMS: Both acute pancreatitis (AP) and pancreatic cancer (PC) have been areas of focus for studies of incretin drugs. This 5-year prospective cohort study aimed to quantify possible associations between liraglutide and risk of AP and PC compared to other antidiabetic drugs (ADs). MATERIALS AND METHODS: Patients initiating liraglutide or other ADs and enrolled in a United States health plan (2010-2014) were included. Comparisons of AP and PC incidence rates were made between matched cohorts of liraglutide initiators and initiators of other ADs...
April 4, 2019: Diabetes, Obesity & Metabolism
Kiyohide Nunoi, Yuichi Sato, Kohei Kaku, Akihiro Yoshida, Hideki Suganami
AIMS: Little is known about whether sodium intake is associated with the clinical effects of SGLT2 inhibitors (SGLT2is); however SGLT2is may increase urinary sodium excretion. Thus, we investigated the impact of daily sodium intake on the estimated glomerular filtration rate (eGFR) via an SGLT2i, tofogliflozin (TOFO), in patients with type 2 diabetes (T2D). METHODS: Analysis of individual-level data on 775 T2D patients in TOFO Phase 3 trials was performed. Adjusted changes in variables during 52 weeks of TOFO therapy were compared according to basal daily salt intake (DSI), which was measured based on estimated daily urinary sodium excretion using the Tanaka formula...
April 3, 2019: Diabetes, Obesity & Metabolism
Sarah J Hallberg, Nancy E Dockter, Jake A Kushner, Shaminie J Athinarayanan
Clinical Practice Guidelines (CPG) are not new, but they are growing in number. A modern definition of CPG was set forth in 1992 by the Institute of Medicine and updated in 2011: "Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options."1 This article is protected by copyright. All rights reserved.
April 3, 2019: Diabetes, Obesity & Metabolism
Tetsuro Tsujimoto, Hiroshi Kajio
There is little evidence on whether non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin interact in secondary cardiovascular prevention in type 2 diabetic patients. This is an observational study using data from the Action to Control Cardiovascular Risk in Diabetes and Action to Control Cardiovascular Risk in Diabetes Follow-on studies. Hazard ratios (HRs) for mortality with 95% confidence intervals (95%CIs) were calculated using the Cox proportional hazard models to compare the time to death in patients taking and not taking aspirin who were simultaneously taking or not taking NSAIDs...
April 3, 2019: Diabetes, Obesity & Metabolism
E Patorno, C Gopalakrishnan, K G Brodovicz, A Meyers, D B Bartels, J Liu, M Kulldorff, S Schneeweiss
BACKGROUND: There are limited real-world data on the comparative cardiovascular (CV) safety of linagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4i) available since May 2011. OBJECTIVES: We aimed to evaluate the safety of linagliptin vs. other glucose-lowering medications in a multi-year monitoring program using insurance claims data. METHODS: In two commercial U.S. claims databases, we identified three pairwise 1:1 propensity score (PS) matched cohorts of type 2 diabetes (T2D) patients ≥18 years initiating linagliptin or a comparator [other DPP-4i (n=31,492 pairs), pioglitazone (n=23,316 pairs), or 2nd generation sulfonylureas (n=19,731 pairs)] between May 2011 and December 2015...
April 2, 2019: Diabetes, Obesity & Metabolism
Dionysis Spanopoulos, Hajra Okhai, Francesco Zaccardi, Abby Tebboth, Brendan Barrett, Michael Busse, Joanne Webb, Kamlesh Khunti
AIMS: Renal function, measured by estimated glomerular filtration rate (eGFR), varies over time. This study aimed to characterize the longitudinal variability of eGFR in people with type 2 diabetes mellitus (T2DM), including variation between categories and individuals. METHODS: People with T2DM and sufficient recorded serum creatinine measurements were identified from the Clinical Practice Research Datalink (T2DM diagnosis from 1st January 2009-1st January 2011 with five years' follow-up)...
April 2, 2019: Diabetes, Obesity & Metabolism
Samuel Seidu, Pinar Topsever, Clare Elizabeth Hambling, Francesc Xavier Cos, Kamlesh Khunti
BACKGROUND: Guideline bodies recommend less strict glycaemic targets in older people with diabetes. It is uncertain whether the benefits of deintensification or de-prescribing, commonly employed by clinicians to achieve the less strict targets, outweighs the harms in these patients. We conducted a systematic review of published evidence, to assess deintensification approaches and rates and evaluate the harms and benefits of deintensification with antidiabetic medication and other therapies amongst older people (≥ 65 years) with type 2 diabetes with or without cardiometabolic conditions...
April 1, 2019: Diabetes, Obesity & Metabolism
Ronnie Aronson, Alexander Abitbol, Katherine S Tweden
AIMS: The Eversense® XL (Senseonics, Maryland USA) is an implantable continuous glucose monitoring (CGM) system. This study is the first investigation of its performance through 180 days in a primarily adolescent population with type 1 diabetes (T1D). MATERIALS AND METHODS: This prospective, single-center, single-arm, 180-day study evaluated the effectiveness and safety of the implantable CGM system in Canadian adolescent and adult subjects with T1D. Accuracy measures included mean absolute relative difference (MARD), 15/15% agreement between CGM glucose and blood glucose (BG) measured by Yellow Springs Instrument (YSI), and Surveillance Error Grid analysis...
April 1, 2019: Diabetes, Obesity & Metabolism
Wenying Yang, Jianhua Ma, Guoyue Yuan, Ling Li, Min Zhang, Yibing Lu, Xinhua Ye, Weihong Song, Ming Liu, Jun Wu, Riqiu Chen, Yunguang Li, Xia Zhang, Nan Cui, Jinkui Yang
The optimal fasting blood glucose (FBG) target to achieve an HbA1c <7.0% in type 2 diabetes (T2D) patients remains controversial. This open-label trial randomized (1:3:3) 947 adults with uncontrolled T2D (HbA1c >7% to ≤10.5%) on 1-3 oral antidiabetic drugs to an FBG target of 3.9<FBG≤5.6 mmol/L (Group 1), 3.9<FBG≤6.1 mmol/L (Group 2), or 3.9<FBG≤7.0 mmol/L (Group 3). Targets were achieved using a pre-defined insulin glargine 100 U/mL titration scheme. The primary endpoint was the proportion of patients achieving an HbA1c <7...
April 1, 2019: Diabetes, Obesity & Metabolism
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