In The News

Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Cardiovascular Events, Death, and Major Safety Outcomes in Adults With Type 2 Diabetes

March 18, 2016. This systematic review and meta-analysis was conducted to assess the effect of sodium-glucose cotransporter-2 (SGLT-2) inhibition on cardiovascular (CV) events, death, and safety outcomes in patients with type 2 diabetes (T2D). Following a thorough literature search, final data evaluated included 6 regulatory submissions (N=37,525 patients) and 57 published trials (N=33,385), representing 7 SGLT-2 inhibitor drugs.

Polypharmacy in the Aging Patient: A Review of Glycemic Control in Older Adults With Type 2 Diabetes

March 8, 2016. This review was conducted to help clarify the substantial uncertainty surrounding type 2 diabetes treatment in older adults. Specifically, it evaluated data from 4 large randomized clinical trials (selected because they provide the majority of evidence used to guide diabetes therapy). The authors noted a lack of data in patients older than 80 years of age. Additionally, among patients provided with intensive glycemic control, observable improvements in micro- and macrovascular complications were not observed for 8-10 years.

Effect of CPAP on Glycemic Control in Patients with Obstructive Sleep Apnea and Type 2 Diabetes. A Randomized Clinical Trial

February 24, 2016. This 6-month, open-label, parallel-arm, randomized clinical trial allocated 50 patients with obstructive sleep apnea, type 2 diabetes (T2D), and A1C levels ≥6.5% to treatment with continuous positive airway pressure (CPAP) or no CPAP for 6 months. The study objectives were to evaluate the impact of CPAP on patient A1C levels, as well as the determinants of benefits observed. Specifically, investigators measured Homeostasis Model Assessment and Qualitative Insulin Sensitivity Check Index scores, as well as systemic biomarkers.

Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study

February 22, 2016. This secondary analysis of data from the Diabetes Prevention Program Outcomes Study (DPPOS) followed patients for approximately 13 years to assess the risk of vitamin B12 deficiency with long-term metformin use. Investigators found that low B12 levels (≤203 pg/mL) were significantly more common at 5 years in patients taking metformin versus placebo (4.3% vs 2.3%, P=0.02), but not at 13 years (7.4% vs 5.4%, P=0.12).

AACE Consensus Conference on Continuous Glucose Monitoring Issues Statement

March 2016. Participants in a recent Consensus Conference on Continuous Glucose Monitoring (CGM) held by the American Association of Clinical Endocrinologists (AACE) agreed that access to CGM should be available to all patients who could benefit from it. The conference addressed 4 key questions related to CGM technology: 1) physician/patient benefit from expanded CGM use; 2) the relevance and reporting of CGM data; 3) interpretation and reporting of CGM data; and 4) currently available clinical data.

AACE/ACE Release Their 2016 Outpatient Glucose Monitoring Consensus Statement

February 10, 2016. The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have announced the publication of their outpatient glucose monitoring consensus statement. The statement provides detailed analyses to support precise recommendations for the type of system and frequency of use for either self-monitoring blood glucose therapy or continuous glucose monitoring to reduce short- and long-term complications of diabetes.

ACCORD Trial Follow-up: 9-Year Effects of 3.7 Years of Intensive Glycemic Control on Cardiovascular Outcomes

February 2016. This study reports on the long-term follow-up of patients in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. The original ACCORD trial evaluated the impact of a mean 3.7 years of intensive vs standard glycemic control in patients with type 2 diabetes and other cardiovascular (CV) risk factors. The study found a neutral effect on the composite CV outcome, increased CV and total mortality, and reduced nonfatal myocardial infarction (MI).

Heart Failure Outcomes With Empagliflozin in Patients With Type 2 Diabetes at High Cardiovascular Risk: Results of the EMPA-REG OUTCOME Trial

January 26, 2016. This follow-on study to the EMPA-REG (Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes) OUTCOME trial in patients with type 2 diabetes (T2D) and high cardiovascular risk evaluated heart failure–related outcomes across all patient groups (empagliflozin 10 mg, 25 mg, or placebo; N=7,020). Investigators found that treatment with empagliflozin improved heart failure–related hospitalization and cardiovascular mortality rates (5.7% in patients treated with empagliflozin, 8.5% in placebo; P<0.001).

Sustained Efficacy of Insulin Pump Therapy versus Multiple Daily Injections in Type 2 Diabetes: 12-month Data From the OpT2mise Randomized Trial

February 8, 2016. This randomized, controlled study was developed to compare insulin pump versus multiple daily injection (MDI) therapy in patients with type 2 diabetes receiving basal and prandial insulin. Following a 2-month dose-optimization period, patients (N=331) with elevated A1C levels (mean 9.0%) were randomized to pump therapy or MDI for 6 months. Investigators found significantly reduced A1C levels in pump compared with MDI patients (-1.1% vs -0.4%, respectively; P<0.001). These improvements were maintained in the pump therapy group through 12 months.

Markers of Beta-Cell Failure Predict Poor Glycemic Response to GLP-1 Therapy in Type 2 Diabetes

February 2016. This prospective analysis evaluated clinical responses in 620 patients with type 2 diabetes treated with a GLP-1 receptor agonist (GLP-1RA) to determine whether clinical characteristics and markers of beta-cell failure are associated with individual response to GLP-1RA use. Participants were required to have an A1C level >7.5% and were followed for 6 months.