In The News

Prospective Cohort Study Gives Insight to the Lifetime Risk of Developing Impaired Glucose Metabolism and the Probability of Diabetes Progression

November 10, 2015. A prospective, population-based cohort analysis calculated the lifetime risk for developing impaired glucose metabolism, the progression from prediabetes to diabetes, and the progression to insulin use for patients with diabetes. The study, published in The Lancet, used data from 10,050 participants from the Rotterdam Study, collected from April 1997 to January 2012, to investigate the risk of progression through the range of glucose impairments.

New Algorithm to Guide Individualized Glycemic Goals in Patients With Type 2 Diabetes Developed Based on a Global Survey of Leading Diabetologists

October 30, 2015. In response to recent observations demonstrating the need for individually adjusted glycemic targets for patients with type 2 diabetes mellitus, a survey was conducted to identify a global consensus on the extent to which specific patient parameters, characteristics, and comorbidities should influence these individualized targets. The survey solicited responses from 244 key opinion-leading diabetologists around the world, of which 151 (61.9%) responded.

New EMPA-REG Outcome Results: Empagliflozin Reduces Risk for Heart Failure Endpoints

November 9, 2015. New data from the EMPA-REG Outcome study were presented at the American Heart Association Scientific Sessions. This evaluation of the cardiovascular (CV) safety of the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin found that patients taking empagliflozin had a decreased risk for CV death (hazard ration [HR] = 0.62; 95% confidence interval [CI] 0.49-0.77) and heart failure–related death or hospitalization (HR= 0.61; 95% CI 0.47-0.79). Other heart failure–related endpoints were also positive for empagliflozin.

Liraglutide Effective and Weight Loss Sustained After 3 Years for Prediabetes Patients

November 6, 2015. Researchers at the Obesity Week 2015 conference reported on a 3-year extension of the SCALE (Satiety and Clinical Adiposity—Liraglutide Evidence in Nondiabetic and Diabetic People) Trial. Initially, 2254 patients were randomized 2:1 to liraglutide 3.0 mg or placebo. Both groups were also provided with dietary advice, and 1128 patients completed the full 160 weeks of the trial. Patients receiving liraglutide had a lower risk for developing diabetes vs placebo (1.8% vs 6.2%) and also had a mean weight loss of 6.1% of body weight (vs 1.9% for placebo).

Large Registry Study Documents Excess Mortality Rates Among People With Type 2 Diabetes

October 29, 2015. This Swedish registry-based study compared patients with type 2 diabetes and controls to assess mortality risk based on patient age, level of glycemic control, and degree of renal complications. Investigators found that the excess risks of all-cause and cardiovascular death increased with younger age, poor glycemic control, and more severe renal complications (assessed using albumin measurements). However, this risk relationship diminished as patients reached older ages.

AACE/ACE Scientific and Clinical Review: Association of SGLT2 Inhibitors and DKA

October 27, 2015. The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) organized a gathering of US and European experts to conduct a rigorous examination of potential issues surrounding sodium-glucose cotransporter-2 (SGLT2) inhibitors and their possible relationship to diabetic ketoacidosis (DKA).

Long-term Effects of Lifestyle Intervention or Metformin on Diabetes Development and Microvascular Complications Over 15-Year Follow-up: The Diabetes Prevention Program Outcomes Study

November 2015. This study evaluated the long-term beneficial effects of the original 3-year Diabetes Prevention Program (DPP) on microvascular outcomes. The original DPP intervention groups comprised lifestyle intervention and treatment with metformin or placebo. At the end of the DPP, all participants were provided with lifestyle training and/or ongoing metformin treatment, with 88% of the original cohort followed from September 2002 to January 2014 by the DPP Outcomes Study.

Potential Impact of Prescribing Metformin According to Estimated Glomerular Filtration Rate Rather Than Serum Creatinine

November 2015. Some professional societies have recommended using estimated glomerular filtration rate (eGFR) instead of serum creatinine to determine patient eligibility for metformin treatment. This study used data from the 1999-2010 National Health and Nutrition Examination Survey to evaluate the potential impact of these recommendations on metformin eligibility among US adults. Four eGFR equations were evaluated; all expanded the population for whom metformin is likely safe (from 86,900 to 834,800 individuals) or indeterminate (784,700 to 1,636,000).

Case Report Links Bullous Pemphigoid With Linagliptin Treatment

October 14, 2015. This report of cases describes 2 patients with bullous pemphigoid (BP) associated with the use of the dipeptidyl peptidase-4 (DPP-4) inhibitor linagliptin for treatment of type 2 diabetes. Drug-induced BP has also been reported in association with the DPP-4 inhibitors sitagliptin and vildagliptin. You can follow this link to review the case study.

Insulin Dose and Cardiovascular Mortality in the ACCORD Trial

October 13, 2015. This post-hoc analysis of data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial evaluated insulin exposure data over 5 years in 10,163 patients. The investigators hypothesized that exposure to injected insulin would increase cardiovascular (CV) mortality. Before adjustment for covariates, a higher dose insulin was associated with increased risk of CV death (hazard ratios [HRs] per 1 unit/kg/day 1.83 [1.45, 2.31], 2.29 [1.62, 3.23], and 3.36 [2.00, 5.66] for total, basal, and prandial insulin, respectively).

US Food and Drug Administration Diabetes Update: Dipeptidyl Peptidase-4 Inhibitors for Type 2 Diabetes May Cause Severe Joint Pain

October 6, 2015. The US Food and Drug Administration (FDA) has issued a warning that that the type 2 diabetes medicines sitagliptin, saxagliptin, linagliptin, and alogliptin may cause joint pain that can be severe and disabling. Specifically, the FDA has added a new Warning and Precaution to the labels of all medicines in this drug class, known as dipeptidyl peptidase-4 (DPP-4) inhibitors. The FDA advises that patients should contact their health care professional right away if they experience severe and persistent joint pain.

The Impact of Nocturnal Hypoglycemia on Sleep in Subjects With Type 2 Diabetes

September 25, 2015. This single-blind crossover trial evaluated the impact of nocturnal hypoglycemia on sleep patterns and counterregulatory hormones in 26 patients with type 2 diabetes (T2D). Patients attended 2 nighttime sleep studies—1 normoglycemic and 1 hypoglycemic. Patient glucose levels were controlled during sleep using hyperinsulinemic glucose clamping. On the hypoglycemic night, the plasma glucose infusion was turned off until glucose levels ranged from 48.6 mg/dL to 50.4 mg/dL for 15 minutes. Patients were subsequently returned to normoglycemia.

December 9

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.