In The News

FDA Approves Label Update for Dulaglutide to Include Use in Combination With Basal Insulin

February 8, 2017. The US Food and Drug Administration has approved a label update for the glucagon-like-1 (GLP-1) receptor agonist dulaglutide. Dulaglutide is now approved for use in combination with basal insulin in adults with type 2 diabetes. This update makes dulaglutide the first GLP-1 receptor agonist indicated for combination use with mealtime insulin or basal insulin.

Chronic Liraglutide Therapy Induces an Enhanced Endogenous Glucagon-like Peptide-1 Secretory Response in Early Type 2 Diabetes

January 2017. This study evaluated the impact of chronic liraglutide therapy on endogenous glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Fifty-one patients with type 2 diabetes (mean duration, 2.6 years, +/- 1.9 years) were randomized for 48 weeks to subcutaneous liraglutide or placebo. Patients received an oral glucose tolerance test (OGTT) every 12 weeks, with GLP-1 and GIP area under the curve (AUC) measured at 0, 30, 60, 90, and 120 minutes. No between-group differences were observed for AUC GIP.

Use of Incretin Agents and Risk of Acute and Chronic Pancreatitis: A Population-Based Cohort Study

January 2017. This population-based matched cohort study was conducted in a United Kingdom population to assess pancreatitis risk in patients with type 2 diabetes receiving incretin therapy (either dipeptidyl peptidase-4 inhibitors or glucagon-like peptide-1 receptor agonists). Adult patients (N=182,428) using ≥1 diabetes medication (excluding insulin) were matched to controls without diabetes.

Insulin-Requiring Versus Noninsulin-Requiring Diabetes and Thromboembolic Risk in Patients With Atrial Fibrillation

January 31, 2017. This prospective, real-world, multicenter study evaluated the impact of insulin vs no insulin therapy on thromboembolic risk in patients with diabetes and atrial fibrillation (AF) being treated with anticoagulation therapy. Rates of stroke and systemic embolism were compared over 1 year based on patient diabetes and insulin use status.

American Association of Clinical Endocrinologists/American College of Endocrinology Make Substantial Updates to Dyslipidemia Clinical Practice Guidelines

January 30, 2017. The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) today announced the online publication of its updated clinical practice guidelines for dyslipidemia management and atherosclerosis prevention. These guidelines introduce a new cardiovascular risk category (“Extreme Risk”), along with far-reaching lipid management goals.

Basal Insulin Degludec (Tresiba) Approved for Teens and Children as Young as 1 Year Old With Diabetes

January 30, 2017. The US Food and Drug Administration has approved an expanded pediatric indication for insulin degludec (Tresiba). With this indication, degludec can now be used to treat patients as young as 1 year old with type 1 or type 2 diabetes. Insulin degludec was approved for adult use in January 2016. Available research indicates that, compared with basal insulin glargine, degludec requires fewer daily injections, allows greater dosing flexibility, and is associated with a flatter blood glucose profile and less hypoglycemia.

Lowest Glucose Variability and Hypoglycemia Are Observed With the Combination of a GLP-1 Receptor Agonist and Basal Insulin (VARIATION Study)

February 2017. This cohort analysis evaluated the glucose variability (GV) and the hypoglycemia rates (defined as blood glucose less than 70 mg/dL) associated with 4 common insulin regimens in patients with type 2 diabetes. Patients (N=160) were recruited from endocrinology clinics and were required to be on a stable insulin regimen for a minimum of 6 months with A1C levels ≤7.5%.

2017 Update for Type 2 Diabetes Comprehensive Management Algorithm Published by American Association of Clinical Endocrinologists, American College of Endocrinology

January 2017. The American Association of Clinical Endocrinologists and the American College of Endocrinology announced the publication of an update to their Comprehensive Type 2 Diabetes Management Algorithm. Designed to serve as a practical and easy-to-use decision-making tool for medical management, the 2017 algorithm emphasizes obesity as an underlying risk factor for type 2 diabetes and its microvascular complications.

US Centers for Medicare & Medicaid Services to Recognize CGMs for Treatment Decisions in Diabetes

January 12, 2017. The US Centers for Medicare & Medicaid Services (CMS) has released a determination that continuous glucose monitoring (CGM) devices are now classified as "durable medical equipment," making them eligible for CMS coverage on a case-by-case basis. Most private payers already provide coverage for CGM devices, and multiple national guidelines recommend their use.

Combination Therapy With Exenatide Plus Pioglitazone Versus Basal/Bolus Insulin in Poorly Controlled Patients With Type 2 Diabetes on Sulfonylurea Plus Metformin: The Qatar Study

January 17, 2017. This randomized controlled trial evaluated the efficacy of combination pioglitazone plus exenatide compared with basal-bolus insulin in a patient cohort (N=231) with long-standing type 2 diabetes and inadequately controlled blood glucose (A1C >7.5%). All patients were currently being managed with metformin plus a sulfonylurea; mean patient baseline A1C was ~10%, and patients were followed for 12 months. Treatment with the pioglitazone/exenatide combination led to mean A1C reductions of 6.1%. Patients who used insulin achieved a mean A1C of 7.1%.

FDA Approves Expanded Indication for Dexcom G5 Continuous Glucose Monitor

December 20, 2016. The US Food and Drug Administration has approved an expanded indication for Dexcom's G5 Mobile Continuous Glucose Monitoring System. The G5 Mobile continuous glucose monitoring device can now be used alone, without supplementary fingerstick glucose testing, to measure blood glucose levels and make diabetes treatment decisions. This is the first US-approved continuous glucose monitoring system to receive this indication.

Efficacy and Effectiveness of Screen and Treat Policies in Type 2 Diabetes Prevention

January 4, 2017. This systematic review and meta-analysis was conducted to assess the diagnostic accuracy (sensitivity and specificity) of A1C and fasting plasma glucose (FPG) used as screening tests for prediabetes and the efficacy of lifestyle or metformin intervention in preventing the transition from prediabetes to type 2 diabetes (T2D). The final analysis included 49 screening studies and 50 intervention trials. A1C was not sensitive (0.49) or specific (0.79) in detecting prediabetes, while FPG was not sensitive (0.25) but was highly specific (0.94).

AACE Resource Center

The AACE Diabetes Resource Center is a compendium of educational tools that enable AACE members to take the lead in implementation of diabetes practice guidelines and also assist other members of their healthcare team in the formulation and delivery of education and guidelines with the goal of improving care for patients with diabetes in their communities.