The Prevalence of Diabetic Microvascular Complications in China and the USA
AbstractPurpose of ReviewDiabetes can lead to development of devastating microvascular complications, such as nephropathy, retinopathy, and peripheral sensory and autonomic neuropathy. While China and the USA both face the threat of this major public health challenge, the literature is limited in describing similarities and differences in the prevalence, and risk factors for the development, of diabetic microvascular complications between these two countries.Recent FindingsThe current review discusses the following: (1) the most recent evidence on prevalence of diabetic microvascular complications in China and the USA (inc...
Source: Current Diabetes Reports - April 9, 2021 Category: Endocrinology Source Type: research

The Relationship Between Type 2 Diabetes, NAFLD, and Cardiovascular Risk
AbstractPurpose of ReviewNonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are strongly associated. Both also associate with an increased risk of cardiovascular disease (CVD).Recent FindingsSeveral studies have provided evidence that NAFLD could be an independent CVD risk factor. Given the strong association between NAFLD and T2DM, assessing the independent CV effect of these two conditions remains challenging. However, patients with T2DM and NAFLD exhibit higher risk of CVD compared with T2DM without NAFLD suggesting a potential synergistic increase of CV risk in patients with both T2DM and NAFL...
Source: Current Diabetes Reports - March 19, 2021 Category: Endocrinology Source Type: research

Diabetes in People with HIV
AbstractPurpose of ReviewTo discuss the diagnosis, treatment, and complications of diabetes in people with HIV (PWH) and to review HIV-related factors that may contribute to the development of diabetes or alter decisions in the care and treatment of PWH with diabetes.Recent FindingsFor those patients with atherosclerotic cardiovascular disease, heart failure, and/or chronic kidney disease, GLP-1 receptor agonists and SGLT-2 inhibitors should be considered for use. Evidence for this recommendation is, however, based on studies that were not conducted in populations consisting solely of PWH.SummaryDiabetes is a significant c...
Source: Current Diabetes Reports - March 17, 2021 Category: Endocrinology Source Type: research

Body Composition Methods in Adults with Type 2 Diabetes or at Risk for T2D: a Clinical Review
AbstractPurpose of ReviewThe aim of this study is to summarize anthropometric and advanced methods used to assess body composition in adults diagnosed with type 2 diabetes (T2D) or at risk for T2D that provide clinically relevant information about T2D disease-related complications or risk factors.Recent FindingsAnthropometry is commonly used in clinical settings; however, provides unreliable estimates of fat mass, fat-free mass, and body fat distribution for metabolic health assessments compared to advanced techniques such as bioelectrical impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA), computerized tomog...
Source: Current Diabetes Reports - March 17, 2021 Category: Endocrinology Source Type: research

Brain Health in Children with Type 1 Diabetes: Risk and Protective Factors
AbstractPurpose of ReviewTo synthesize findings from studies of neurocognitive complications in children with type 1 diabetes (T1D) and highlight potential risk and protective factors.Recent FindingsEmerging evidence suggests that hyperglycemia and time in range may be more important for brain development than episodes of hypoglycemia. Further, diabetic ketoacidosis (DKA) at the time of T1D diagnosis appears to be a particular risk factor for neurocognitive complications, particularly deficits in executive function skills and memory, with differences in cerebral white matter microstructure seen via advanced magnetic resona...
Source: Current Diabetes Reports - March 14, 2021 Category: Endocrinology Source Type: research

Cell Therapy for Critical Limb Ischemia: Advantages, Limitations, and New Perspectives for Treatment of Patients with Critical Diabetic Vasculopathy
AbstractPurpose of ReviewTo provide a highlight of the current state of cell therapy for the treatment of critical limb ischemia in patients with diabetes.Recent FindingsThe global incidence of diabetes is constantly growing with consequent challenges for healthcare systems worldwide. In the UK only, NHS costs attributed to diabetic complications, such as peripheral vascular disease, amputation, blindness, renal failure, and stroke, average £10 billion each year, with cost pressure being estimated to get worse. Although giant leaps forward have been registered in the scope of early diagnosis and optimal glycaemic con...
Source: Current Diabetes Reports - March 2, 2021 Category: Endocrinology Source Type: research

The Relationship Between Executive Functioning, Type 1 Diabetes Self-Management Behaviors, and Glycemic Control in Adolescents and Young Adults
AbstractPurpose of ReviewUnderstanding barriers to self-management behaviors and glycemic stability may inform specific needs for behavior change in adolescents and young adults with type 1 diabetes (T1D). The current review aims to systematically synthesize the literature on the relationships between executive functioning, self-management, and A1C in adolescents and young adults with T1D. Fifteen studies were retained in the current review. Study quality assessment for the majority of the studies were “Fair” or “Good.”Recent FindingsThis review highlights several advances in research design, includ...
Source: Current Diabetes Reports - February 22, 2021 Category: Endocrinology Source Type: research

Auto-antigen and Immunomodulatory Agent –Based Approaches for Antigen-Specific Tolerance in NOD Mice
AbstractPurpose of ReviewType 1 diabetes (T1D) can be managed by insulin replacement, but it is still associated with an increased risk of microvascular/cardiovascular complications. There is considerable interest in antigen-specific approaches for treating T1D due to their potential for a favorable risk-benefit ratio relative to non-specific immune-based treatments. Here we review recent antigen-specific tolerance approaches using auto-antigen and/or immunomodulatory agents in NOD mice and provide insight into seemingly contradictory findings.Recent FindingsAlthough delivery of auto-antigen alone can prevent T1D in NOD mi...
Source: Current Diabetes Reports - February 6, 2021 Category: Endocrinology Source Type: research

Genetic Contribution to Non-alcoholic Fatty Liver Disease and Prognostic Implications
AbstractPurpose of ReviewNon-alcoholic fatty liver disease (NAFLD) is a major and increasing health burden, with the potential to overwhelm hepatology services. However, only a minority of patients develop advanced liver disease. The challenge is early identification of patients at risk of progression. This review aims to summarize current knowledge on the genetic predisposition to NAFLD, and its implications for prognostication and risk stratification.Recent FindingsPNPLA3-I148M is the most robustly associated genetic variant with NAFLD. Recently, variants inTM6SF2,MBOAT7,GCKR andHSD17B13 have also been implicated. NAFLD ...
Source: Current Diabetes Reports - February 5, 2021 Category: Endocrinology Source Type: research

A Model of Adolescent Sleep Health and Risk for Type 2 Diabetes
AbstractPurpose of ReviewThis paper presents a review of the current literature in support of a model explaining the relationships between sleep health and risk for type 2 diabetes in adolescents.Recent FindingsShort sleep duration is associated with risk of developing obesity in youth. Sleep restriction increases energy expenditure, but also increases hunger, appetite, and food intake, causing positive energy balance, impacting appetite-regulating hormones, and leading to increased eating late at night. Insufficient sleep may lead to reduced physical activity and greater sedentary behaviors. In addition, short sleep durat...
Source: Current Diabetes Reports - January 15, 2021 Category: Endocrinology Source Type: research

Managing Patients with Insulin Pumps and Continuous Glucose Monitors in the Hospital: to Wear or Not to Wear
AbstractPurpose of ReviewAs the prevalence of diabetes mellitus in the USA continues to rise, so does the popularity of diabetes management devices such as continuous glucose monitors (CGMs) and insulin pumps. The use of this technology has been shown to improve outpatient glycemic outcomes and quality of life and oftentimes may be continued in the hospital setting. Our aim is to review the current guidelines and available evidence on the continuation of insulin pumps and CGMs in the inpatient setting.Recent FindingsPatients with diabetes are at higher risk for hospitalizations and complications due to hyper- or hypoglycem...
Source: Current Diabetes Reports - January 15, 2021 Category: Endocrinology Source Type: research

Role of Glucose Metabolism and Mitochondrial Function in Diabetic Kidney Disease
AbstractPurpose of ReviewDiabetic kidney disease (DKD) continues to be the primary cause of chronic kidney disease in the USA and around the world. The numbers of people with DKD also continue to rise despite current treatments. Certain newer hypoglycemic drugs offer a promise of slowing progression, but it remains to be seen how effective these will be over time. Thus, continued exploration of the mechanisms underlying the development and progression of DKD is essential in order to discover new treatments. Hyperglycemia is the main cause of the cellular damage seen in DKD. But, exactly how hyperglycemia leads to the activ...
Source: Current Diabetes Reports - January 15, 2021 Category: Endocrinology Source Type: research

The Financial Impact of an Inpatient Diabetes Management Service
ConclusionIDMS may play an important role in helping both academic and community hospitals to improve the quality of diabetes care and reduce costs. Clinicians and policymakers can utilize existing literature to build a compelling business case for IDMS to hospital administrations and state legislatures in the era of value-based healthcare. (Source: Current Diabetes Reports)
Source: Current Diabetes Reports - January 15, 2021 Category: Endocrinology Source Type: research

Novel Immunomodulatory Approaches for Porcine Islet Xenotransplantation
AbstractPurpose of ReviewPorcine islet xenotransplantation is a promising alternative to overcome the shortage of organ donors. For the successful application of islet xenotransplantation, robust immune/inflammatory responses against porcine islets should be thoroughly controlled. Over the last few decades, there have been numerous attempts to surmount xenogeneic immune barriers. In this review, we summarize the current progress in immunomodulatory therapy for the clinical application of porcine islet xenotransplantation.Recent FindingsLong-term graft survival of porcine islets was achieved by using anti-CD154 Ab-based reg...
Source: Current Diabetes Reports - January 12, 2021 Category: Endocrinology Source Type: research

Diabetes Complications in Racial and Ethnic Minority Populations in the USA
AbstractPurpose of ReviewRacial and ethnic minority populations have a higher burden of diabetes-related complications. There have been many epidemiologic studies to better define these racial/ethnic disparities in diabetes outcomes with additional studies offering interventions to mitigate them. This narrative review highlights the epidemiologic trends in diabetes complications specific to racial and ethnic minorities and underscores differences in microvascular and macrovascular complications of diabetes, health care utilization, and diabetes prevention efforts and also reviews interventions aimed to reduce racial/ethnic...
Source: Current Diabetes Reports - January 9, 2021 Category: Endocrinology Source Type: research

The β-Cell Genomic Landscape in T1D: Implications for Disease Pathogenesis
This article reviews the current knowledge on the genetics of T1D with a specific focus on genetic variation in pancreatic islet regulatory networks and its implication to T1D risk and disease development.Recent FindingsAccumulating evidence suggest an active role of β cells in T1D pathogenesis. Based on such observation several studies aimed in mapping T1D risk variants acting at the β cell level. Such studies unravel T1D risk loci shared with type 2 diabetes (T2D) and T1D risk variants potentially interfering with β-cell responses to external stimuli.SummaryThe characterization of regulatory genomics maps ...
Source: Current Diabetes Reports - January 2, 2021 Category: Endocrinology Source Type: research

Periodic and Intermittent Fasting in Diabetes and Cardiovascular Disease
AbstractPurpose of ReviewCardiovascular disease (CVD) is one of the leading causes of death globally. Nutrition plays a central role in CVD risk by affecting aging, adiposity, glycemia, blood pressure, cholesterol, inflammation, and other risk factors and can affect CVD risk not only based on calorie intake and dietary composition but also the timing and range of meals. This review evaluates the effects of fasting, fasting-mimicking diets, and time-restricted eating on the reduction of CVD risk factors and provides initial data on their potential to serve as CVD prevention and treatment therapies.Recent FindingsIntermitten...
Source: Current Diabetes Reports - December 10, 2020 Category: Endocrinology Source Type: research

Cardiometabolic Morbidity and Mortality with Smoking Cessation, Review of Recommendations for People with Diabetes and Obesity
AbstractPurpose of ReviewObesity is closely linked with the pathogenesis of type 2 diabetes (T2DM) and cardiovascular disease (CVD), and whilst smoking cessation is associated with weight gain, there are concerns that this weight gain may offset the benefit of CVD risk reduction especially in those with considerable post-cessation weight gain. The aim of this narrative review is to evaluate recent evidence on smoking cessation and cardiometabolic outcomes and discuss limitations of current knowledge and studies.Recent FindingsNicotine is a key player in modulating energy balance by influencing lipid storage in adipose tiss...
Source: Current Diabetes Reports - December 8, 2020 Category: Endocrinology Source Type: research

Sleep Extension: A Potential Target for Obesity Treatment
AbstractPurpose of ReviewSleep and obesity share a bidirectional relationship, and weight loss has been shown to enhance sleep. Aiming to extend sleep on its own or as part of a lifestyle intervention may attenuate health consequences of short sleep. This review highlights several sleep extension approaches, discusses feasibility of each, and summarizes findings relevant to obesity.Recent FindingsSleep extension in response to experimental sleep restriction demonstrates partial rescue of cardiometabolic dysfunction in some but not all studies. Adequate sleep on a nightly basis may be necessary for optimal health. While ini...
Source: Current Diabetes Reports - December 4, 2020 Category: Endocrinology Source Type: research

Use of Machine Learning Approaches in Clinical Epidemiological Research of Diabetes
AbstractPurpose of ReviewMachine learning approaches —which seek to predict outcomes or classify patient features by recognizing patterns in large datasets—are increasingly applied to clinical epidemiology research on diabetes. Given its novelty and emergence in fields outside of biomedical research, machine learning terminology, techniques, and r esearch findings may be unfamiliar to diabetes researchers. Our aim was to present the use of machine learning approaches in an approachable way, drawing from clinical epidemiological research in diabetes published from 1 Jan 2017 to 1 June 2020.Recent FindingsMachine...
Source: Current Diabetes Reports - December 3, 2020 Category: Endocrinology Source Type: research

Evidence for Mental Health Contributions to Medical Care in Diabetes Management: Economic and Professional Considerations
AbstractPurpose of ReviewThis paper considers the potential contributions of behavioral health providers to interprofessional, collaborative treatment for diabetes. We have the following objectives: (1) review the behavioral health complications, risks, burdens, and costs associated with diabetes management and consider the role of behavioral health providers in treating mental health concerns specific to diabetes; (2) highlight two frameworks for incorporating behavioral health into diabetes treatment, and review the empirical support for each; and (3) consider the financial feasibility of integrating behavioral health se...
Source: Current Diabetes Reports - November 28, 2020 Category: Endocrinology Source Type: research

Impact of Type 2 Diabetes Mellitus and Antidiabetic Medications on Bone Metabolism
AbstractPurpose of ReviewThis review focuses on the complex interactions between hyperglycemia and bone fragility and the effects of antidiabetic medications on bone metabolism.Recent FindingsType 2 diabetes (T2D) is associated with increased risk of bone fracture even in those with increased or normal bone mineral density (BMD). The pathophysiology of diabetic bone disease is not completely understood, but it is thought to be multifactorial and associated with complex cross talk among factors such as AGEs, IGF-1, enteric hormones, and pro-inflammatory cytokines. Treatment for T2D may have an impact on bone metabolism.Summ...
Source: Current Diabetes Reports - November 27, 2020 Category: Endocrinology Source Type: research

Caring for Hospitalized Patients with Diabetes Mellitus, Hyperglycemia, and COVID-19: Bridging the Remaining Knowledge Gaps
AbstractPurpose of ReviewThis review discusses the interplay between coronavirus disease 2019 (COVID-19, caused by SARS-CoV-2 infection), diabetes mellitus, and hyperglycemia in the hospital setting. There are data emerging about diabetes and hyperglycemia, their prevalence, and potential risks in the setting of SARS-CoV-2 infection and COVID-19.Recent FindingsIt is known that viral infections exert effects on beta cell function and insulin resistance. Therefore, much can be learned about SARS-CoV-2/COVID-19 from examining these known relationships. Such pathophysiological underpinnings may unlock greater understanding as ...
Source: Current Diabetes Reports - November 26, 2020 Category: Endocrinology Source Type: research

The Role of Aspirin for Preeclampsia Prevention in Women with Diabetes
AbstractPurpose of ReviewA diagnosis of type I or type 2 diabetes confers heightened risk for virtually every obstetric and perinatal complication, with the incidence of superimposed preeclampsia representing a particularly high-risk scenario. Over the past three decades, studies have investigated the role of aspirin in preeclampsia prevention, yielding some promising results for certain at-risk groups, yet unconvincing evidence of benefit among women with pre-pregnancy diabetes. The purpose of this review is to present the current evidence base for aspirin use in pregnancy as a means of mitigating preeclampsia risk in the...
Source: Current Diabetes Reports - November 24, 2020 Category: Endocrinology Source Type: research

Does Weight Loss Improve Clinical Outcomes in Overweight and Obese Patients with Heart Failure?
AbstractPurpose of ReviewObesity increases the risk of new onset heart failure (HF), and particularly HF with preserved ejection fraction (HFpEF). Despite the observations of favorable clinical outcomes in HF patients with obesity in general, sometimes referred to as the “obesity paradox,” it is important to recognize that severe obesity is associated with worse clinical outcomes. This review summarizes the effects of obesity treatment on cardiovascular health and HF clinical outcomes.Recent FindingsTreatment for obesity utilizes a variety of modalities to achieve purposeful weight loss including lifestyle inte...
Source: Current Diabetes Reports - November 24, 2020 Category: Endocrinology Source Type: research

Sodium-Glucose Cotransporter Type 2 (SGLT-2) Inhibitors and Ketogenesis: the Good and the Bad
AbstractPurpose of ReviewThe micro/macrovascular complications of diabetes cause considerable morbidity and premature mortality. The SGLT2 inhibitors are the first diabetes medications with significant benefits on microvascular disease (nephropathy) and macrovascular cardiovascular disease. In this review, we evaluate one of the potential mechanisms for these cardiorenal benefits —the production of ketones, their benefits, and risks.Recent FindingsIn recent cardiovascular outcome trials (CVOTs), the SGLT2 inhibitors demonstrated significant cardiorenal benefits and they are now approved to reduce CV events/death, hea...
Source: Current Diabetes Reports - November 23, 2020 Category: Endocrinology Source Type: research

Diabetes Risk and Control in Multi-ethnic US Immigrant Populations
AbstractPurpose of ReviewThe goal of this review is to assess current evidence on diabetes risk and control among adult immigrants in the USA.Recent FindingsPatterns of diabetes risk in US immigrants may reflect global diabetes trends. Asian, Black, and Latinx immigrants all see a diabetes disadvantage relative to US-born Whites. Diabetes risk in Asian immigrants also surpasses US-born Asians. Relative diabetes risk among all groups increases with time in the USA. Research to explain patterns in diabetes risk and control among immigrants has broadened from lifestyle factors to include multi-level, life course influences on...
Source: Current Diabetes Reports - November 20, 2020 Category: Endocrinology Source Type: research

Pancreas-on-a-Chip Technology for Transplantation Applications
AbstractPurpose of ReviewHuman pancreas-on-a-chip (PoC) technology is quickly advancing as a platform for complex in vitro modeling of islet physiology. This review summarizes the current progress and evaluates the possibility of using this technology for clinical islet transplantation.Recent FindingsPoC microfluidic platforms have mainly shown proof of principle for long-term culturing of islets to study islet function in a standardized format. Advancement in microfluidic design by using imaging-compatible biomaterials and biosensor technology might provide a novel future tool for predicting islet transplantation outcome....
Source: Current Diabetes Reports - November 18, 2020 Category: Endocrinology Source Type: research

Implementation of Technology-Delivered Diabetes Self-care Interventions in Clinical Care: a Narrative Review
This article provides an overview of the methods and results of studies examining the implementation of technology-delivered diabetes self-care interventions into clinical care. We focus specifically on patient-facing behavioral interventions delivered with technology (e.g., text messaging, apps, websites).Recent FindingsEleven articles were included in the review. Most studies (n = 9) examined barriers and facilitators to implementation, while about half (n = 5) integrated the intervention into clinical care and evaluated implementation and/or effectiveness. Only six studies applied a theory or...
Source: Current Diabetes Reports - November 18, 2020 Category: Endocrinology Source Type: research

Review of Intravenous and Subcutaneous Electronic Glucose Management Systems for Inpatient Glycemic Control
AbstractPurpose of ReviewThe goal of this review is to summarize current literature on electronic glucose management systems (eGMS) and discuss their benefits and disadvantages in the inpatient setting.Recent FindingsWe review different versions of commercially available eGMS: Glucommander ™ (Glytec, Greenville, SC), EndoToolR (MD Scientific LLC, Charlotte, NC), GlucoStabilizer ™ (Medical Decision Network, Charlottesville, VA), GlucoCare™ (Pronia Medical Systems, KY), and discuss advantages such as reducing rates of hypoglycemia, hyperglycemia, and glycemic variability. In addition, eCGMs offer a uniform ...
Source: Current Diabetes Reports - November 9, 2020 Category: Endocrinology Source Type: research

A Question of Tolerance —Antigen-Specific Immunotherapy for Type 1 Diabetes
AbstractPurpose of ReviewAntigen-specific immunotherapy (ASI) is a long sought-after goal for type 1 diabetes (T1D), with the potential of greater long-term safety than non-specific immunotherapy. We review the most recent advances in identification of target islet epitopes, delivery platforms and the ongoing challenges.Recent FindingsIt is now recognised that human proinsulin contains a hotspot of epitopes targeted in people with T1D. Beta-cell neoantigens are also under investigation as ASI target epitopes. Consideration of the predicted HLA-specificity of the target antigen for subject selection is now being incorporate...
Source: Current Diabetes Reports - November 9, 2020 Category: Endocrinology Source Type: research

Genetic Studies of Gestational Diabetes and Glucose Metabolism in Pregnancy
We describe these studies in the context of the larger body of literature on type 2 diabetes (T2D) and glycemic trait genomics.Recent FindingsWe reviewed 23 genetic association studies for GDM and performed a meta-analysis, which revealed variants at eight T2D loci significantly associated with GDM after the Bonferroni correction. These studies suggest that GDM and T2D share a number of genetic risk loci. Only two unbiased genome-wide association studies (GWASs) have successfully revealed genetic associations for GDM and related glycemic traits in pregnancy. A GWAS for GDM in Korean women identified two loci (nearCDKAL1 an...
Source: Current Diabetes Reports - November 9, 2020 Category: Endocrinology Source Type: research

Social Determinants of Poor Management of Type 2 Diabetes Among the Insured
AbstractPurpose of ReviewEven with insurance coverage increasing over time among the population with diabetes, a large proportion continues to have poorly controlled disease. The purpose of this narrative literature review is to describe the social determinants of poor management of type 2 diabetes among the insured population and illustrate drivers of poor outcomes beyond insurance coverage.Recent FindingsDespite the provision of health insurance, social determinants play a significant role in shaping diabetes outcomes, especially for economic instability (employment, out-of-pocket expenses associated with diabetes manage...
Source: Current Diabetes Reports - November 5, 2020 Category: Endocrinology Source Type: research

Novel Targets in Glucose Homeostasis and Obesity —Lesson from Rare Mutations
AbstractPurpose of ReviewObesity and diabetes have already become the second largest risk factor for cardiovascular disease. During the last decade, remarkable advances have been made in understanding the human genome ’s contribution to glucose homeostasis disorders and obesity. A few studies on rare mutations of candidate genes provide potential genetic targets for the treatment of diabetes and obesity. In this review, we discussed the detailed findings of these studies and the possible causalities between spe cific genetic variations and dysfunctions in energy or glucose homeostasis. We are optimistic that novel th...
Source: Current Diabetes Reports - October 31, 2020 Category: Endocrinology Source Type: research

The Road to Approval: a Perspective on the Role of Icosapent Ethyl in Cardiovascular Risk Reduction
AbstractPurpose of ReviewEpidemiological studies have long suggested the cardiovascular benefits of omega-3 fatty acids (OM3FAs). However, until recently, clinical trials using OM3FAs have been largely negative with respect to their cardioprotective effects. In this review, we aim to summarize key clinical trials, examine the clinical benefits of eicosapentaenoic acid (EPA) and potential mechanisms, and review the changes in guidelines and recommendations.Recent FindingsThe Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) has demonstrated significant cardiovascular mortality benefits o...
Source: Current Diabetes Reports - October 23, 2020 Category: Endocrinology Source Type: research

Tissue-Specific Fructose Metabolism in Obesity and Diabetes
The objective of this review is to provide up-to-date and comprehensive discussion of tissue-specific fructose metabolism in the context of diabetes, dyslipidemia, and nonalcoholic fatty liver disease (NAFLD).Recent FindingsIncreased intake of dietary fructose is a risk factor for a myriad of metabolic complications. Tissue-specific fructose metabolism has not been well delineated in terms of its contribution to detrimental health effects associated with fructose intake. Since inhibitors targeting fructose metabolism are being developed for the management of NAFLD and diabetes, it is essential to recognize how inability of...
Source: Current Diabetes Reports - October 15, 2020 Category: Endocrinology Source Type: research

What Makes Sodium-Glucose Co-Transporter-2 Inhibitors Stand out in Heart Failure?
AbstractPurpose of ReviewWe highlight the unique properties of the sodium-glucose cotransporter-2 (SGLT-2 inhibitors) which may lend favorably to their efficient integration in the background of other heart failure (HF) therapies. We also discuss the unique aspects of SGLT-2 inhibitor dosing, lack of titration needs, effects on kidney function and electrolytes, diuretic activity, and safety in the high-risk peri-hospitalization window.Recent FindingsDapagliflozin was recently approved for the treatment of heart failure with reduced ejection fraction (HFrEF), irrespective of the presence or absence of type 2 diabetes mellit...
Source: Current Diabetes Reports - October 11, 2020 Category: Endocrinology Source Type: research

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent
AbstractPurpose of ReviewLatin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes.Recent FindingsThe prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Do...
Source: Current Diabetes Reports - October 10, 2020 Category: Endocrinology Source Type: research

Do Women with Diabetes Need More Intensive Action for Cardiovascular Reduction than Men with Diabetes?
AbstractPurpose of ReviewThis narrative review makes the case for greater efforts to reduce cardiovascular disease (CVD) risk in women with diabetes.Recent FindingsIn a recent meta-analysis including five CVOTs of diabetes medications with 46,606 subjects, women (vs men) with type 2 diabetes had a higher relative risk for stroke (RR 1.28; 95% CI 1.09, 1.50) and heart failure (1.30; 1.21, 1.40). Prior studies found higher “within-gender” RR for CVD mortality in women with diabetes although men have an absolute higher risk. Women with prior gestational diabetes mellitus (GDM) have a 2-fold higher CVD risk than th...
Source: Current Diabetes Reports - October 9, 2020 Category: Endocrinology Source Type: research

Integrating Genetics and the Plasma Proteome to Predict the Risk of Type 2 Diabetes
AbstractPurpose of the ReviewProteins are the central layer of information transfer from genome to phenome and represent the largest class of drug targets. We review recent advances in high-throughput technologies that provide comprehensive, scalable profiling of the plasma proteome with the potential to improve prediction and mechanistic understanding of type 2 diabetes (T2D).Recent FindingsTechnological and analytical advancements have enabled identification of novel protein biomarkers and signatures that help to address challenges of existing approaches to predict and screen for T2D. Genetic studies have so far revealed...
Source: Current Diabetes Reports - October 8, 2020 Category: Endocrinology Source Type: research

Role of Agents for the Treatment of Diabetes in the Management of Nonalcoholic Fatty Liver Disease
AbstractPurpose of ReviewNonalcoholic fatty liver disease (NAFLD) is an often unrecognized complication of type 2 diabetes (T2DM) associated with significant economic burden and poor long-term hepatic and extrahepatic outcomes. Our goal is to review evidence about the complex association between NAFLD and T2DM and highlight the potential for disease co-management with the available medications used for the treatment of diabetes.Recent FindingsA milieu of metabolic factors such as insulin resistance, glucotoxicity, and lipotoxicity, as well as genetics and other factors, contribute to the pathogenesis and co-existence of NA...
Source: Current Diabetes Reports - October 4, 2020 Category: Endocrinology Source Type: research

Thyroid Hormone Signalling Alteration in Diabetic Nephropathy and Cardiomyopathy: a “Switch” to the Foetal Gene Programme
In this study, we will analyse how diabetes induces the reactivation of organs ’ developmental programmes and growth, discuss how thyroid hormone (TH) signalling orchestrates these processes, and suggest novel strategies for exploiting TH-mediated reparative and regenerative properties.Recent FindingsDiabetes is a global pandemic that poses an enormous threat to human health. The kidney and the heart are among the organs that are the most severely damaged by diabetes over time. They undergo profound metabolic, structural, and functional changes that may be due (at least partially) to a recapitulation of their early d...
Source: Current Diabetes Reports - September 27, 2020 Category: Endocrinology Source Type: research

A Review of the Current Evidence: Impact of Metabolic Surgery on Diabetes Outcomes and Obesity-Associated Macrovascular Complications
AbstractPurpose of ReviewType 2 diabetes (T2D) and obesity are comorbidities that generally progress with time even when non-invasive therapies are prescribed. Indeed, weight loss that is achieved with behavioral modification alone is generally inconsistent and often short-lived. In contrast, although patients do experience weight regain with metabolic surgery, they still benefit from a significant net decrease in weight. As a result, T2D remission can be achieved in up to 60% of patients within 2  years after surgery. However, it is unknown if the positive effects of metabolic surgery extend to macrovascular disease ...
Source: Current Diabetes Reports - September 27, 2020 Category: Endocrinology Source Type: research

The Role of Socioeconomic Status in Latino Health Disparities Among Youth with Type 1 Diabetes: a Systematic Review
AbstractPurpose of ReviewType 1 diabetes (T1D) incidence is growing faster among Latino than non-Latino White youth, but ethnic disparities in self-management behaviors and HbA1c are unclear. Socioeconomic status (SES) is a key factor in T1D, which may confound or contribute to disparities in Latino pediatric T1D management. A systematic review examined whether ethnic differences in pediatric T1D outcomes occur and are independent of socioeconomic status (SES).Recent FindingsLatino youth displayed lower self-management and higher HbA1c in approximately half of the identified studies prior to including SES in analyses. Ethn...
Source: Current Diabetes Reports - September 24, 2020 Category: Endocrinology Source Type: research

Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy in Children and Adolescents with Type 2 Diabetes
AbstractPurpose of ReviewAmong adults with type 2 diabetes (T2D), cognitive behavioral therapy (CBT), acceptance and commitment therapy, and mindfulness interventions have demonstrated improvement in depression, anxiety, and glycemic control. We assessed whether these treatment modalities have shown usefulness in adolescents with T2D or at risk for T2D.Recent FindingsData are limited on the use of the abovementioned therapeutic interventions and include only adolescent girls at risk for T2D. CBT was as useful as health education sessions. At 1  year, greater decreases in depression, insulin resistance, and BMI were ob...
Source: Current Diabetes Reports - September 21, 2020 Category: Endocrinology Source Type: research

Mechanisms of Congenital Malformations in Pregnancies with Pre-existing Diabetes
AbstractPurpose of ReviewFetuses of diabetic mothers are at increased risk for congenital malformations. Research in recent decades using animal and embryonic stem cell models has revealed many embryonic developmental processes that are disturbed by maternal diabetes. The aim of this review is to give clinicians a better understanding of the reasons for rigorous glycemic control in early pregnancy, and to provide background to guide future research.Recent FindingsMouse models of diabetic pregnancy have revealed mechanisms for altered expression of tissue-specific genes that lead to malformations that are more common in dia...
Source: Current Diabetes Reports - September 11, 2020 Category: Endocrinology Source Type: research

Dyslipidemia in Pediatric Type 2 Diabetes Mellitus
AbstractPurpose of ReviewCardiovascular (CV) disease is a major cause of mortality in type 2 diabetes mellitus (T2D). Dyslipidemia is prevalent in children with T2D and is a known risk factor for CVD. In this review, we critically examine the epidemiology, pathophysiology, and recommendations for dyslipidemia management in pediatric T2D.Recent FindingsDyslipidemia is multifactorial and related to poor glycemic control, insulin resistance, inflammation, and genetic susceptibility. Current guidelines recommend lipid screening after achieving glycemic control and annually thereafter. The desired lipid goals are low-density li...
Source: Current Diabetes Reports - September 8, 2020 Category: Endocrinology Source Type: research

Assessment of Risks and Benefits of Beta Cell Replacement Versus Automated Insulin Delivery Systems for Type 1 Diabetes
AbstractPurpose of ReviewCurrent approaches to insulin replacement in type 1 diabetes are unable to achieve optimal levels of glycemic control without substantial risk of hypoglycemia and substantial burden of self-management. Advances in biology and technology present beta cell replacement and automated insulin delivery as two alternative approaches. Here we discuss current and future prospects for the relative risks and benefits for biological and psychosocial outcomes from the perspective of researchers, clinicians, and persons living with diabetes.Recent FindingsBeta cell replacement using pancreas or islet transplant ...
Source: Current Diabetes Reports - August 30, 2020 Category: Endocrinology Source Type: research

The Contribution of Kidney Disease to Cognitive Impairment in Patients with Type 2 Diabetes
AbstractPurpose of ReviewThis review focuses on the relationships between diabetes, cognitive impairment, and the contribution of kidney disease.Recent FindingsWe review the independent contributions of parameters of kidney disease, including albuminuria, glomerular filtration, bone/mineral metabolism, and vitamin D synthesis, on cognitive performance in patients with diabetes. Potential pathophysiologic mechanisms underlying these associations are discussed highlighting gaps in existing knowledge. Finally, effects of the dialysis procedure on the brain and cognitive performance are considered. Emphasis is placed on novel ...
Source: Current Diabetes Reports - August 27, 2020 Category: Endocrinology Source Type: research

Fibroblast Growth Factor 23 and Adverse Clinical Outcomes in Type 2 Diabetes: a Bitter-Sweet Symphony
AbstractPurpose of ReviewFibroblast growth factor 23 (FGF23) is a key phosphate-regulating hormone that has been associated with adverse outcomes in patients with chronic kidney disease (CKD). Emerging data suggest that FGF23 plays a specific role in type 2 diabetes, partly independent of kidney function. We aimed to summarize current literature on the associations between FGF23 and outcomes in patients with type 2 diabetes with or without CKD.Recent FindingsSeveral cohort studies have shown strong associations between plasma FGF23 and cardiovascular outcomes in diabetic CKD. Moreover, recent data suggest that FGF23 are el...
Source: Current Diabetes Reports - August 27, 2020 Category: Endocrinology Source Type: research