In The News

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).

Updated FDA Review Concludes That Use of Type 2 Diabetes Medicine Pioglitazone May Be Linked to an Increased Risk of Bladder Cancer

December 12, 2016. The US Food and Drug Administration (FDA) has conducted an updated review of the type 2 diabetes medication pioglitazone and confirmed that this drug may be linked to an increased risk of bladder cancer. The labels of pioglitazone-containing drugs already provide warning information regarding bladder cancer risk; this labeling will be updated with information from the current FDA review.

Glucose Concentrations Less Than 54 mg/dL Should Be Reported in Clinical Trials: A Joint Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

December 2016. The American Diabetes Association and the European Association for the Study of Diabetes have released a statement agreeing that glucose levels lower than 54 mg/dL (3.0 mmol/L) should be reported in clinical trials evaluating drugs for the treatment of diabetes. This position statement outlines the groups’ decision-making process and rationale for selecting this threshold and also indicates that hypoglycemia levels of less than 70 mg/dL do not need to be routinely reported in clinical trials.

FDA Approves Empagliflozin to Reduce Cardiovascular Death in Adults With Type 2 Diabetes

December 2, 2016. The US Food and Drug Administration has approved a new indication for empagliflozin to reduce the risk of cardiovascular (CV) death in adult patients with type 2 diabetes (T2D) and cardiovascular disease. This decision is based on a postmarketing study of more than 7,000 patients with T2D and CV disease. This study found that empagliflozin reduced the risk of CV death vs placebo when added to standard of care therapies for diabetes and atherosclerotic CV disease.

FDA Approves One Drop Chrome Mobile Blood Glucose Monitoring System

December 6, 2016. The US Food and Drug Administration has approved the mobile blood glucose (BG) monitoring system One Drop Chrome and a subscription upgrade service, One Drop Premium. The One Drop Chrome device wirelessly transmits BG data directly via the One Drop app (available on both iOS and Android). The app can be used to log information related to glucose, diet, activity, and insulin. The platform offers users actionable insights based on their data.

The Effect of Liraglutide on Renal Function: A Randomized Clinical Trial

December 2016. This randomized controlled crossover study examined the effect of liraglutide on 24-h urinary albumin excretion rate (UAER) among patients with type 2 diabetes and persistent albuminuria (urinary albumin-to-creatinine ratio >30 mg/g) and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2. After placebo treatment, geometric mean (IQR) UAER was 199 (81-531) mg/24-h, mean measured GFR (mGFR) was 75 mL/min/1.73 m2, 24-h systolic blood pressure (SBP) was 145/80 mm Hg, and A1C was 7.7%.

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