Glycemic Control in Hospitalized Stroke Patients: A Review
AbstractPurpose of ReviewThe purpose of this review is to discuss clinical trials involving glycemic control in hospitalized stroke patients and to review oral medications used in glycemic control. GLP-1 agonists, which have some preliminary studies in ischemic stroke, will also be reviewed.Recent FindingsUntil recently, glycemic control targets in hospitalized stroke patients remained unclear. The SHINE (Stroke Hyperglycemia Insulin Network Effort) trial demonstrated no significant difference between aggressive versus standard of care glycemic control in the acute ischemic stroke patient.SummaryAlthough SHINE demonstrated...
Source: Current Diabetes Reports - December 1, 2021 Category: Endocrinology Source Type: research
Epidemiology of Type 2 Diabetes in Indigenous Communities in the United States
AbstractPurpose of ReviewThe present review focuses on the epidemiology of type 2 diabetes (T2D) in Indigenous communities in the continental United States (U.S.) —including disease prevention and management—and discusses special considerations in conducting research with Indigenous communities.Recent FindingsPrevious studies have reported the disparately high prevalence of diabetes, especially T2D, among Indigenous peoples in the U.S. The high prevalence and incidence of early-onset T2D in Indigenous youth relative to that of all youth in the U.S. population pose challenges to the prevention of complications of diabet...
Source: Current Diabetes Reports - November 22, 2021 Category: Endocrinology Source Type: research
Multi-level Diabetes Prevention and Treatment Interventions for Native People in the USA and Canada: a Scoping Review
AbstractPurpose of ReviewThis scoping literature review seeks to answer the question “What is known in the existing literature about multi-level diabetes prevention and treatment interventions for Native people living in the United States and Canada?”Recent FindingsMulti-level interventions to prevent and/or treat chronic diseases, such as diabetes, promise to help individuals who experience health disparities related to social determinants of health. As described by the socio-ecological model, such interventions mobilize support through a combination of individual, interpersonal, organizational, community, and policy ...
Source: Current Diabetes Reports - November 7, 2021 Category: Endocrinology Source Type: research
Interpreting Absolute and Relative Risk Reduction in the Context of Recent Cardiovascular Outcome Trials in Patients with Type 2 Diabetes
AbstractPurpose of ReviewThe cardiovascular benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) have increased the focus of type 2 diabetes mellitus (T2DM) care on comprehensive cardiovascular risk reduction. Herein, we review the results of the cardiovascular outcomes trials of SGLT2i and GLP-1 RA, discuss the concepts of relative vs. absolute risk reduction in the context of these trials, and highlight the importance of individualized risk assessment when applying trial results to clinical practice.Recent FindingsTo enable personalized treatment approach...
Source: Current Diabetes Reports - November 6, 2021 Category: Endocrinology Source Type: research
Assessing Glycemic Control Using CGM for Women with Diabetes in Pregnancy
This article reviews the types of CGM currently available, the glucose metrics which correlate with pregnancy outcomes, endocrine organization recommendations, clinical considerations for CGM implementation, and anticipated directions for future research.Recent FindingsCGM use during pregnancy is increasing, and recommendations for use have been incorporated into many organizations ’ consensus guidelines. Increased time spent within a target range of 63–140 mg/dL and lower mean glucose are associated with lower risk of neonatal complications including large for gestational age infants. Use of CGM during pregnancy can ...
Source: Current Diabetes Reports - November 4, 2021 Category: Endocrinology Source Type: research
Novel Treatments for Diabetic Macular Edema and Proliferative Diabetic Retinopathy
AbstractPurpose of ReviewDiabetic retinopathy (DR), a common cause of vision loss, is projected to increase worldwide, and is associated with significant morbidity. The current standard-of-care treatments can preserve and significantly improve vision in many patients affected by DR. However, challenges such as heavy treatment burden and refractory disease remain. The purpose of this review is to highlight and discuss investigative agents in development for the treatment of DR.Recent FindingsThere are several novel agents with unique mechanisms that may offer greater durability and efficacy compared to existing drugs. Some ...
Source: Current Diabetes Reports - November 1, 2021 Category: Endocrinology Source Type: research
Role of Optical Coherence Tomography Angiography Imaging in Patients with Diabetes
AbstractPurpose of ReviewOcular manifestations in patients with diabetes mellitus (DM) can present as microvascular changes. These microvascular changes can be challenging to identify on exams, and imaging technologies have commonly aided in the diagnosis and management of patients with DM. Optical coherence tomography angiography (OCTA) provides noninvasive image segmentation of various layers of the retina and choroid. Also, post-processing of images and associated quantitative measurements offer potential clinical enhancements. Our aim is to review the current evidence on the utility of OCTA for patients with DM.Recent ...
Source: Current Diabetes Reports - October 19, 2021 Category: Endocrinology Source Type: research
Asymptomatic Diabetic Cardiomyopathy: an Underrecognized Entity in Type 2 Diabetes
AbstractPurpose of ReviewType 2 diabetes (T2D) is associated with an increased risk of heart failure (HF), with diabetic cardiomyopathy (DbCM) referring to abnormal heart structure in the absence of other driving cardiac factors such as hypertension, coronary artery disease (CAD), and valvular heart disease. Stage B DbCM is commonly asymptomatic and represents a form of stage B HF; DbCM thus represents a transitional phenotype prior to onset of symptomatic HF. The pathogenesis of DbCM is not fully elucidated but involves hyperglycemia, insulin resistance, increased free fatty acids (FFA), lipotoxicity, oxidative stress, ad...
Source: Current Diabetes Reports - September 27, 2021 Category: Endocrinology Source Type: research
The Impact of COVID-19 on Diabetic Retinopathy Monitoring and Treatment
AbstractPurpose of ReviewDiabetic retinopathy (DR) is one of the leading causes of vision loss worldwide. Although screening and early treatment guidelines for DR have significantly reduced the disease burden, restrictions related to the COVID-19 pandemic have changed real-world practice patterns in the management of DR. This review summarizes evolving guidelines and outcomes of the treatment of DR in the setting of the pandemic.Recent FindingsIntravitreal injections for DR have decreased significantly globally during the pandemic, ranging from approximately 30 to nearly 100% reduction, compared to corresponding timepoints...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
