Association Between Diabetes, Diabetic Retinopathy, and Glaucoma
AbstractPurpose of ReviewThe strength of the relationship between diabetes, diabetic retinopathy (DR), and glaucoma remains controversial. We review evidence supporting and refuting this association and explore mechanistic pathological and treatment relationships linking these diseases.Recent FindingsWhile studies have shown diabetes/DR may increase the risk for glaucoma, this remains inconsistently demonstrated. Diabetes/DR may contribute toward glaucomatous optic neuropathy indirectly (either by increasing intraocular pressure or vasculopathy) or through direct damage to the optic nerve. However, certain elements of diab...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
Metformin in Pregnancy for Women with Type 2 Diabetes: a Review
AbstractPurpose of ReviewTo review the current evidence for the use of metformin in pregnancy for women with type 2 diabetes.Recent FindingsA large, multicenter, double-blind randomized controlled trial found that women with type 2 diabetes in pregnancy treated with metformin as an adjunct to insulin therapy had less gestational weight gain, insulin requirements, caesarian sections, macrosomia, and neonatal adiposity, but more neonates were small for gestational age (SGA) compared with insulin alone. It is unclear if the higher number of SGA infants are a direct result of metformin exposure or mediated through other effect...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
What the Jackson Heart Study Has Taught Us About Diabetes and Cardiovascular Disease in the African American Community: a 20-year Appreciation
AbstractPurpose of ReviewThe burden of cardiometabolic diseases such as cardiovascular disease (CVD) and type 2 diabetes (T2D) is pronounced among African Americans. Research has shown that behavioral, social, metabolic, psychosocial, and genetic risk factors of CVD and T2D are closely interwoven. Approximately 20 years ago, the Jackson Heart Study (JHS) was established to investigate this constellation of risk factors.Recent FindingsFindings from neighborhood studies emphasize the importance of social cohesion and physical environment in the context CVD and T2D risk. Socioeconomic status factors such as income and educa...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
Postpartum Use of Weight Loss and Metformin for the Prevention of Type 2 Diabetes Mellitus: a Review of the Evidence
AbstractPurpose of ReviewAs many as 70% of patients diagnosed with gestational diabetes mellitus (GDM) will go on to develop type 2 diabetes (T2DM) within their lifetimes. Implementing strategies to mitigate this progression in the postpartum period when patients are already connected to care is essential in optimizing lifelong health for our patients. Both lifestyle modification and metformin have been investigated as options to reduce type 2 diabetes risk in patients with a history of GDM.Recent FindingsThe current model for postpartum testing and care of patients with GDM has been shown to have poor uptake rates. Simila...
Source: Current Diabetes Reports - September 8, 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
Association Between Diabetes, Diabetic Retinopathy, and Glaucoma
AbstractPurpose of ReviewThe strength of the relationship between diabetes, diabetic retinopathy (DR), and glaucoma remains controversial. We review evidence supporting and refuting this association and explore mechanistic pathological and treatment relationships linking these diseases.Recent FindingsWhile studies have shown diabetes/DR may increase the risk for glaucoma, this remains inconsistently demonstrated. Diabetes/DR may contribute toward glaucomatous optic neuropathy indirectly (either by increasing intraocular pressure or vasculopathy) or through direct damage to the optic nerve. However, certain elements of diab...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
Metformin in Pregnancy for Women with Type 2 Diabetes: a Review
AbstractPurpose of ReviewTo review the current evidence for the use of metformin in pregnancy for women with type 2 diabetes.Recent FindingsA large, multicenter, double-blind randomized controlled trial found that women with type 2 diabetes in pregnancy treated with metformin as an adjunct to insulin therapy had less gestational weight gain, insulin requirements, caesarian sections, macrosomia, and neonatal adiposity, but more neonates were small for gestational age (SGA) compared with insulin alone. It is unclear if the higher number of SGA infants are a direct result of metformin exposure or mediated through other effect...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
What the Jackson Heart Study Has Taught Us About Diabetes and Cardiovascular Disease in the African American Community: a 20-year Appreciation
AbstractPurpose of ReviewThe burden of cardiometabolic diseases such as cardiovascular disease (CVD) and type 2 diabetes (T2D) is pronounced among African Americans. Research has shown that behavioral, social, metabolic, psychosocial, and genetic risk factors of CVD and T2D are closely interwoven. Approximately 20 years ago, the Jackson Heart Study (JHS) was established to investigate this constellation of risk factors.Recent FindingsFindings from neighborhood studies emphasize the importance of social cohesion and physical environment in the context CVD and T2D risk. Socioeconomic status factors such as income and educa...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
Postpartum Use of Weight Loss and Metformin for the Prevention of Type 2 Diabetes Mellitus: a Review of the Evidence
AbstractPurpose of ReviewAs many as 70% of patients diagnosed with gestational diabetes mellitus (GDM) will go on to develop type 2 diabetes (T2DM) within their lifetimes. Implementing strategies to mitigate this progression in the postpartum period when patients are already connected to care is essential in optimizing lifelong health for our patients. Both lifestyle modification and metformin have been investigated as options to reduce type 2 diabetes risk in patients with a history of GDM.Recent FindingsThe current model for postpartum testing and care of patients with GDM has been shown to have poor uptake rates. Simila...
Source: Current Diabetes Reports - September 8, 2021 Category: Endocrinology Source Type: research
Laser Therapy in the Treatment of Diabetic Retinopathy and Diabetic Macular Edema
AbstractPurpose of ReviewThis review highlights indications and evidence on laser therapy in the management of diabetic retinopathy and diabetic macular edema. Particular focus is placed upon the benefits and limitations of conventional laser photocoagulation versus more modern laser photocoagulation techniques, as well as the role of laser photocoagulation in treatment of diabetic retinopathy and diabetic macular edema with the frequent utilization of pharmacologic, including anti-vascular endothelial growth factor (VEGF), therapy.Recent FindingsLaser photocoagulation remains the gold-standard therapy for the effective, d...
Source: Current Diabetes Reports - September 6, 2021 Category: Endocrinology Source Type: research
Predicting and Preventing Acute Care Re-Utilization by Patients with Diabetes
AbstractPurpose of ReviewAcute care re-utilization, i.e., hospital readmission and post-discharge Emergency Department (ED) use, is a significant driver of healthcare costs and a marker for healthcare quality. Diabetes is a major contributor to acute care re-utilization and associated costs. The goals of this paper are to (1) review the epidemiology of readmissions among patients with diabetes, (2) describe models that predict readmission risk, and (3) address various strategies for reducing the risk of acute care re-utilization.Recent FindingsHospital readmissions and ED visits by diabetes patients are common and costly. ...
Source: Current Diabetes Reports - September 4, 2021 Category: Endocrinology Source Type: research
Management of Complications and Vision Loss from Proliferative Diabetic Retinopathy
AbstractPurpose of ReviewDiabetes can be associated with profound visual loss due to several mechanisms. As the duration of diabetes and blood glucose levels increase, these changes become more severe. The proliferation of new blood vessels, vitreous hemorrhage, and tractional retinal detachments may ultimately result and can be devastating to visual function. New advances, including anti-vascular endothelial growth factor (VEGF) medications and innovative microsurgical instruments, have provided additional methods for the management of diabetic retinopathy in the clinic and in the operating room, leading to improved outco...
Source: Current Diabetes Reports - September 3, 2021 Category: Endocrinology Source Type: research
