Disease progression and treatment response in data-driven subgroups of type 2 diabetes compared with models based on simple clinical features: an analysis using clinical trial data

Publication date: Available online 29 April 2019Source: The Lancet Diabetes &EndocrinologyAuthor(s): John M Dennis, Beverley M Shields, William E Henley, Angus G Jones, Andrew T HattersleySummaryBackgroundResearch using data-driven cluster analysis has proposed five subgroups of diabetes with differences in diabetes progression and risk of complications. We aimed to compare the clinical utility of this subgroup-based approach for predicting patient outcomes with an alternative strategy of developing models for each outcome using simple patient characteristics.MethodsWe identified five clusters in the ADOPT trial (n=4351) using the same data-driven cluster analysis as reported by Ahlqvist and colleagues. Differences between clusters in glycaemic and renal progression were investigated and contrasted with stratification using simple continuous clinical features (age at diagnosis for glycaemic progression and baseline renal function for renal progression). We compared the effectiveness of a strategy of selecting glucose-lowering therapy using clusters with one combining simple clinical features (sex, BMI, age at diagnosis, baseline HbA1c) in an independent trial cohort (RECORD [n=4447]).FindingsClusters identified in trial data were similar to those described in the original study by Ahlqvist and colleagues. Clusters showed differences in glycaemic progression, but a model using age at diagnosis alone explained a similar amount of variation in progression. We found differenc...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research

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Conclusion MethodologyThere were 4 clinical trials approved at the National University Malaysia in collaboration with Cytopeutics (Cyberjaya, Malaysia) which provided the mesenchymal stromal cells (Cyto-MSC) for treatment of acute stroke, heart failure, diabetes with critical limb ischemia and severe deforming osteoarthritis. All patients received 65-130 × 106 Cyto-MSC intravenously. Severity of chronic kidney disease is based on baseline estimated glomerular filtration rate (eGFR) and serum creatinine which are markers of renal dysfunction. These and other blood tests including fasting blood sugar (FBS) and Hba1...
Source: Cytotherapy - Category: Cytology Source Type: research
AbstractStrongyloides stercoralis (S. stercoralis), a human intestinal nematode, can lead to hyper/disseminated (HD) infection in patients treated with corticosteroids. Here, we report a case of strongyloidiasis in a 58-year-old female with a history of rheumatoid arthritis (RA) and type 2 diabetes mellitus (T2DM). The patient presented with abdominal pain and gastrointestinal (GI) bleeding. Stool was negative for parasitic agents in the first direct smear examination, and the patient with the probable diagnosis ofHelicobacter pylori (H. pylori) infection or Crohn ’s disease received antibiotics and corticosteroids. ...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to emphasize the pivotal role of glucagon-like peptide 1 (GLP-1) in tackling the parallel epidemics of obesity and type 2 diabetes (T2DM).Recent FindingsGLP-1-based therapies and in particular GLP-1 receptor agonists (GLP-1 RA) have proven to be effective in lowering blood glucose and decreasing weight. GLP-1 RA not only mitigate these significant medical burdens but also result in weight loss and weight loss independent factors that decrease cardiovascular disease (CVD) and microvascular complications of T2DM, such as diabetic nephropathy.SummaryGLP-1-based therapies ...
Source: Current Obesity Reports - Category: Eating Disorders & Weight Management Source Type: research
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
CONCLUSIONS: Serum ALP level was positively and independently associated with baPWV in men and women, suggesting that an elevated ALP level may be a useful surrogate marker for arterial stiffness in adult men and women. PMID: 31092766 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Publication date: Available online 14 May 2019Source: American Journal of Kidney DiseasesAuthor(s): Andrew S. Allegretti, Wenbin Zhang, Wenjiong Zhou, Tara K. Thurber, Scott P. Rigby, Cynthia Bowman-Stroud, Carlos Trescoli, Pierre Serusclat, Mason W. Freeman, Yuan-Di C. HalvorsenRationale &ObjectiveHyperglycemia exacerbates the progression of chronic kidney disease (CKD), but most glucose-lowering therapies do not address morbidities associated with CKD. Sodium/glucose cotransporter 2 (SGLT2) inhibitors offer potential benefits to patients with diabetes and CKD, but their effectiveness may be diminished with ...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Bardoxolone methyl attenuates inflammation by inducing Nrf2 and suppressing NF- κB. The Bardoxolone Methyl Evaluation in Patients With Chronic Kidney Disease and Type 2 Diabetes (BEACON) trial was a phase 3 placebo-controlled, randomized, double-blind, parallel-group, international, multicenter trial in 2185 patients with type 2 diabetes mellitus and stage 4 chronic kidney dis ease. BEACON was terminated because of safety concerns, largely related to a significant increase in early heart failure events in patients randomized to bardoxolone methyl.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Clinical Trial Source Type: research
ConclusionPreeclamptic women with risk factors for PPCM and women with pePPCM at increased risk of MACE should be followed closely. Further studies are required to determine whether preeclampsia affects the long-term prognosis of women with PPCM.
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
RenalytixAI has won  Break Through Device designation from FDA for KidneyIntelX a technology that could help diagnose kidney disease. This is the first such designation for an AI-enabled diagnostic for kidney disease publicly announced by any company. KidneyIntelx was designed in an effort to curtail the estimated $114 billion annual cost of chronic and end-stage kidney disease to the U.S. healthcare system. “The technology is a combination of a multiplex lab-based test measuring three biomarkers (sTNFR1, sTNFR2 and KIM1) that are shown to be prognostic in nature for rapid progress...
Source: MDDI - Category: Medical Devices Authors: Tags: Digital Health Source Type: news
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