Intensive blood sugar control doesn ’t have lasting cardiovascular benefits for those with diabetes

In 2009, the New England Journal of Medicine published results from the Veterans Affairs Diabetes Trial (VADT). The study found that intensive glucose (blood sugar) control in older men with longstanding type 2 diabetes did not significantly reduce their risk of major cardiovascular (CV) events, including heart attack, stroke, and death from CV causes, compared with standard blood sugar control. Researchers recently reported 15-year follow-up results from VADT. They found that intensive blood sugar control did not exert any “legacy effect”: the intensive blood sugar control group did not enjoy CV benefits 15 years after the start of the study. The Veterans Affairs Diabetes Trial The VADT study originally enrolled over 1,700 veterans with longstanding type 2 diabetes, who were at high risk of cardiovascular disease, and had poorly controlled blood sugar when they enrolled in the study. At the time of enrollment, study participants had been diagnosed with diabetes for an average of 12 years. Their average A1c level, a measure of average blood sugar levels over the previous two to three months, was 9.4%. The participants were randomly assigned to either intensive glucose-lowering therapy or usual care for about 5.6 years. At the completion of the study, there was a significant difference in blood sugar control: the average A1c in the intensive treatment group was 6.9%, while the average A1c in the usual care group was 8.4%. Despite the lower A1c levels, there were no...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diabetes Heart Health Source Type: blogs

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CONCLUSIONS: From this case report, the authors believe NPWTi-d may be more effective in cases with intractable ulcers associated with infection that need better granulation. PMID: 31730514 [PubMed - in process]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
CONCLUSIONS: This retrospective study further supports previous evidence that acellular fish skin graft promotes wound healing in DFUs. In particular, a rapid increase in wound healing was observed during the initial 4 weeks following graft application. This study and review of the literature indicated that fish graft encourages wound healing by enabling the wound to transition from a chronic to an acute stage of healing. PMID: 31730505 [PubMed - as supplied by publisher]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
Learn all about how to detect type 1 diabetes in children and youth: signs, symptoms, and treatments.
Source: Diabetes Mine - Category: Endocrinology Authors: Source Type: blogs
Conclusions/interpretationThis study provides a proof of principle for the use of iPSC-derived immune cells for modelling key cellular interactions in human type 1 diabetes.
Source: Diabetologia - Category: Endocrinology Source Type: research
Conclusions/interpretationShort-term structured strength and balance training did not influence HRQoL but produced sustained improvements in functional status and balance confidence at 6  months. More intensive interventions may be needed to influence HRQoL in these individuals. However, this intervention may be a useful treatment option for individuals with DPN to reduce the risk of falls and injuries.Trial registrationClinicalTrials.gov NCT02115932FundingThis work was supported by the National Medical Research Council, Singapore.
Source: Diabetologia - Category: Endocrinology Source Type: research
AbstractAims/hypothesisDiet is one of the main lifestyle-related factors that can modulate the inflammatory process. Surprisingly the dietary inflammatory index (DII) has been little investigated in relation to type 2 diabetes, and the role of BMI in this relationship is not well established. We studied this association and the role of BMI in the inflammatory process in a large population-based observational study.MethodsA total of 70,991 women from the E3N (Etude Epid émiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale) cohort study were followed for 20 year...
Source: Diabetologia - Category: Endocrinology Source Type: research
AbstractAims/hypothesisCardiovascular disease is the most common comorbidity in type 1 diabetes. However, current guidelines do not include routine assessment of myocardial function. We investigated whether echocardiography provides incremental prognostic information in individuals with type 1 diabetes without known heart disease.MethodsA prospective cohort of individuals with type 1 diabetes without known heart disease was recruited from the outpatient clinic. Follow-up was performed through Danish national registers. The association of echocardiography with major adverse cardiovascular events (MACE) and the incremental p...
Source: Diabetologia - Category: Endocrinology Source Type: research
Conclusions/interpretationOur findings suggest that children who progress to type 1 diabetes have a unique metabolic profile, which is, however, altered with the appearance of islet autoantibodies. Our findings may assist with early prediction of the disease.
Source: Diabetologia - Category: Endocrinology Source Type: research
By WILLIAM H. BESTERMANN JR., MD New Scientific Breakthroughs Can Provide a Longer Healthier Life Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
In conclusion, the impaired in situ activity of RyR2 may also account for the poor overall cardiac outcome reported in MetS patients; hence, the SERCA pump and RyR2 are both attractive potential targets for future therapies. Introduction Metabolic syndrome (MetS) is a cluster of biochemical and physiological risk factors for cardiovascular disease and diabetes mellitus type 2 (DM2); it represents a severe public health problem around the world (Alberti et al., 2009). Risk factors for MetS include obesity (particularly central obesity), elevated triglyceride (TG) levels, low high-density lipoprotein cholesterol (HDL...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
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