In The News

Hypoglycemia When Adding Sulfonylureas to Metformin

August 3, 2016. This systematic review and network meta-analysis was conducted to compare the relative risk of hypoglycemia when adding next-generation sulfonylureas (SUs) to metformin in patients with type 2 diabetes. Thirteen trials of SU therapy and 14 trials of non-SU therapy were analyzed. Investigators found that, compared with glipizide, the odds ratio (OR) for hypoglycemia was lowest with gliclazide (0.22, confidence interval 0.05-0.96), followed by glimepiride (0.40, 0.13-1.27) and glibenclamide (0.21, 0.03-1.48).

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

August 2016. This pooled analysis of 55,292 individuals was conducted using data from a series of Spanish population cohorts to determine the association between type 2 diabetes (T2D) and cause-specific death over 10 years. Participants were required to have no prior history of cardiovascular (CV) disease and to be 35 to 79 years of age.

Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes

July 28, 2016. This analysis of the (Empaglifozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) trial evaluated the long-term renal effects of empagliflozin in patients with type 2 diabetes. Prespecified renal endpoints included: a) incident or worsening nephropathy (progression to macroalbuminuria, doubling of serum creatinine, renal replacement therapy initiation, or death from renal disease); and, b) incident albuminuria.

FDA Approves Lixisenatide (Adlyxin) to Treat Type 2 Diabetes

July 28, 2016. The US Food and Drug Administration has approved the glucagon-like peptide-1 receptor agonist lixisenatide (Adlyxin) as a once-daily injection to improve glycemic control in adults with type 2 diabetes. Click here for full article

A Population-Based Study of All-Cause Mortality and Cardiovascular Disease in Association With Prior History of Hypoglycemia Among Patients With Type 1 Diabetes

July 2016. This study investigated the effects of severe hypoglycemia on all-cause mortality and cardiovascular disease (CVD) incidence in patients with type 1 diabetes (T1D). The study comprised 2 nested case-control studies (total cohort N=10,411) and used a time-density sampling method to identify age- and sex-matched controls between 1997 and 2011. Severe hypoglycemia history was identified within 1, 1 to 3, and 3 to 5 years before the occurrence of study outcomes.

FDA Panel Supports Dexcom Continuous Glucose Monitoring for Insulin Dosing in Patients With Diabetes

July 22, 2016. A US Food and Drug Administration (FDA) advisory panel has voted in favor of allowing the Dexcom G5 Mobile continuous glucose monitoring (CGM) system to be used as a replacement for fingerstick glucose monitoring in patients with diabetes. Currently, this device is indicated for adjunctive use along with self-monitoring of blood glucose to provide trend information and alert patients to high and low blood glucose values.

Coprogression of Cardiovascular Risk Factors in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study

July 2016. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study demonstrated the beneficial effect of intensive therapy on cardiovascular outcomes, while identifying hyperglycemia as a dominant risk factor for patients with type 1 diabetes (T1D). This analysis evaluated the extent to which glycemic exposure influenced long-term changes in established risk factors for cardiovascular disease (CVD) among patients with T1D. Of the surviving DCCT cohort, 96% were enrolled for an additional 20-year observational study.

FDA Approves a Dedicated Syringe to Be Used With Humulin R U-500 Insulin

July 8, 2016. The US Food and Drug Administration (FDA) has approved a dedicated syringe for the administration of Humulin R U-500 insulin. This is now the only device approved for use with the U-500 insulin vial. Since conversions are no longer needed with this new device, the Humulin R U-500 insulin vial label will be updated to remove the dose conversion information for U-100 and tuberculin syringes. Approved syringes for use with Humulin R U-500 insulin vials will only be available with a prescription and should be co-prescribed with U-500 insulin.

Do Patient Characteristics Impact Decisions by Clinicians on Hemoglobin A1C Targets?

June 20, 2016. This retrospective study was conducted to determine whether physicians consider individualized risks and the benefits of tight glycemic control when setting A1C targets. Investigators evaluated National Health and Nutrition Examination Survey (NHANES) data for individuals with self-reported diabetes over an 8-year period between 2005 and 2014.

Efficacy and Safety of Switching From Sitagliptin to Liraglutide in Patients With Type 2 Diabetes (LIRA-SWITCH)

July 2016. This randomized, double-blind, double-dummy, active-controlled 26-week trial was conducted at 86 sites worldwide to confirm the superiority of switching from sitagliptin to liraglutide on glycemic control. Participating patients (N=407) had type 2 diabetes (T2D) managed with metformin and sitagliptin. The primary endpoint was changes in A1C levels, with a secondary endpoint of change in body weight.

Cardiovascular Safety of Empagliflozin In Patients With Type 2 Diabetes: A Meta-analysis

July 2016. This meta-analysis of data from 8 randomized placebo-controlled trials was conducted to evaluate the efficacy and safety of empagliflozin 10 mg and 25 mg once daily in patients with type 2 diabetes and at low/medium and high cardiovascular (CV) risk. The primary endpoint was a 4-point major adverse CV events (MACE) composite of CV death, non-fatal myocardial infarction (MI), non-fatal stroke, and hospitalization for unstable angina. The secondary endpoint was a 3-point MACE composite of CV death, non-fatal MI, and non-fatal stroke.

Persistent Effects of Intensive Glycemic Control on Retinopathy in Type 2 Diabetes in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Follow-On Study

July 2016. This study evaluated whether the beneficial effects of intensive glycemic control and fenofibrate treatment to reduce retinopathy progression in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study persisted in the 4 years beyond the initial study period. Progression was defined as ≥3 steps in the Early Treatment Diabetic Retinopathy Study Scale. At follow-up, all patients had similar A1C levels.

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.