Issues and Events
(Source: Diabetes Care)
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Comment on Sj öholm et al. Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-term Results From the Swedish Obese Subjects Study. Diabetes Care 2022;45:444–450
We were interested by the recent article inDiabetes Care by Sj öholm et al. (1), who reported that the incidence of cancer was reduced 21.3 years after bariatric surgery in patients with diabetes who participated in the Swedish Obese Subjects (SOS) cohort, with an especially promising 60% reduction for the 102 subjects whose diabetes remitted for 10 years, mainly (N = 91) after the intervention. In their discussion, the authors hypothesized that the most plausible mechanism to explain this remarkable result was the reduction of hyperinsulinism; however, the relation between initial serum insulin levels and later cancers w...
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Comment on Oosterwijk et al. High-Normal Protein Intake Is Not Associated With Faster Renal Function Deterioration in Patients With Type 2 Diabetes: A Prospective Analysis in the DIALECT Cohort. Diabetes Care 2022;45:35 –41
In their outstanding report, Oosterwijk et al. (1) show that renal outcome is superior in patients with diabetes fed on a high-protein diet compared with that of patients subjected to normal or low-protein diet. These unforeseen and surprising findings contradict our common practice, as for decades, low-protein diet has been recommended especially for patients with chronic kidney disease (CKD), a strategy aimed at slowing its progression. Protein intake as low as 20 g per day (such as Kempner rice diet) was initially recommended, but presently a better tolerated diet containing 0.7 to 0.8 g of full protein per 1 kg of body...
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Comment on Fahrmann et al. Modification of the Association Between Severe Hypoglycemia and Ischemic Heart Disease by Surrogates of Vascular Damage Severity in Type 1 Diabetes During ∼30 Years of Follow-up in the DCCT/EDIC Study. Diabetes Care 2021;44;2132–2139
Fahrmann et al. (1) reported that, in the 1,441 subjects with type 1 diabetes (T1D) included in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study cohort (none of whom had previous cardiovascular events), the presence of at least one event of severe hypoglycemia (SH) increased the risk of ischemic heart disease (IHD) (death, silent/nonfatal myocardial infarction, revascularization, and confirmed angina) in those patients with higher baseline surrogates of microvascular damage (diabetes duration or steps on the DCCT Early Treatment Diabetic Retinopathy S...
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Comment on Gange et al. Incidence of Proliferative Diabetic Retinopathy and Other Neovascular Sequelae at 5 Years Following Diagnosis of Type 2 Diabetes. Diabetes Care 2021;44:2518 –2526
We were interested by the recent article from Gange et al. (1), who reported that 1.74% of 71,817 individuals with newly diagnosed type 2 diabetes had a proliferative retinopathy 5 years later. The authors mentioned that this incidence was probably underestimated because the patients were not mandated to follow-up at strict intervals, which prompted us to analyze how many of our patients with recent ( ≤5-year duration) type 2 diabetes had a sight-threatening retinopathy. (Source: Diabetes Care)
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Comment on Lachin et al. The Beneficial Effects of Earlier Versus Later Implementation of Intensive Therapy in Type 1 Diabetes. Diabetes Care 2021;44:2225 –2230
The article by Lachin et al. (1) in a recent issue ofDiabetes Care used the Diabetes Control and Complications Trial (DCCT) (2) and the Epidemiology of Diabetes Interventions and Complications (EDIC) (3) data set to model a 10-year period of early intensive glucose control and to demonstrate that this is more effective at reducing the subsequent risk of diabetes complications than an equivalent period of glucose control implemented later after diagnosis. The modeling provides compelling evidence to support the introduction of intensive glucose control soon after diagnosis (1,4). (Source: Diabetes Care)
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Response to Comment on Fahrmann et al. Modification of the Association Between Severe Hypoglycemia and Ischemic Heart Disease by Surrogates of Vascular Damage Severity in Type 1 Diabetes During ∼30 Years of Follow-up in the DCCT/EDIC Study. Diabetes Care 2021;44;2132–2139
We thank Dr. Gonz ález-Clemente et al. (1) for their comments on our article (2). We showed that in the young cohort with type 1 diabetes (T1D) of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study without baseline macrovascular complications, the adverse effect of severe hypoglycemia (SH) history on the cardiovascular system increased with increasing microvascular severity. We have not investigated whether a dose-response relationship exists because of differences in severe hypoglycemia ascertainment in the combined DCCT/EDIC period (2,3). Our results d...
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Response to Comment on Oosterwijk et al. High-Normal Protein Intake Is Not Associated With Faster Renal Function Deterioration in Patients With Type 2 Diabetes: A Prospective Analysis in the DIALECT Cohort. Diabetes Care 2022;45:35 –41
In agreement with expectations expressed in the comment letter by Heyman et al. (1), most of the patients (72%) included in the Diabetes and Lifestyle Cohort Twente used agents that exert renin angiotensin aldosterone system (RAAS) blockade (2). None of the included patients used an inhibitor of sodium –glucose cotransporter 2 (SGLT2). Of note, medication use was assessed at baseline, and there is no information regarding either initiation of an SGLT2 inhibitor or changes in usage and/or dosage of RAAS blockade during follow-up. (Source: Diabetes Care)
Source: Diabetes Care - March 4, 2022 Category: Endocrinology Source Type: research
Circulating Fatty Acids and Genetic Predisposition to Type 2 Diabetes: Gene-Nutrient Interaction Analysis
CONCLUSIONSPlasma concentrations of SFA and MUFA were associated with a higher T2D risk, whereas plasma PUFA and n-6 and n-3 PUFA were related to a lower risk. Circulating MUFA and n-3 PUFA had significant interactions with genetic predisposition to T2D and FA-associated variants. (Source: Diabetes Care)
Source: Diabetes Care - January 28, 2022 Category: Endocrinology Source Type: research
Shortened Leukocyte Telomere Length Is Associated With Glycemic Progression in Type 2 Diabetes: A Prospective and Mendelian Randomization Analysis
CONCLUSIONSShorter rLTL was significantly associated with an increased risk of glycemic progression in individuals with type 2 diabetes, independent of established risk factors. Telomere length may be a useful biomarker for glycemic progression in people with type 2 diabetes. (Source: Diabetes Care)
Source: Diabetes Care - January 27, 2022 Category: Endocrinology Source Type: research
Type 2 Diabetes Partitioned Polygenic Scores Associate With Disease Outcomes in 454,193 Individuals Across 13 Cohorts
CONCLUSIONSOur findings support that genetically driven pathways leading to T2D also predispose differentially to clinical outcomes. (Source: Diabetes Care)
Source: Diabetes Care - January 27, 2022 Category: Endocrinology Source Type: research
Continuous Glucose Monitoring in Adults With Type 1 Diabetes With 35 Years Duration From the DCCT/EDIC Study
CONCLUSIONSIn adults with long-standing type 1 diabetes, short-term blinded CGM profiles revealed frequent clinically significant hypoglycemia (<54 mg/dL) during the night and more time in hyperglycemia during the day. The small subset of participants using routine CGM and insulin pumps had fewer hypoglycemic and hyperglycemic excursions and lower HbA1c levels. Thus, strategies to lower meal-stimulated hyperglycemia during the day and prevent hypoglycemia at night are relevant clinical goals in older patients with type 1 diabetes. (Source: Diabetes Care)
Source: Diabetes Care - January 25, 2022 Category: Endocrinology Source Type: research
Impact of Diabetes Duration on Functional and Clinical Status in Older Adults With Type 1 Diabetes
CONCLUSIONSIn older adults with T1D, duration of diabetes impacts clinical and functional status, independent of age and glycemic control, and should be considered in development of management strategies for safety and success. (Source: Diabetes Care)
Source: Diabetes Care - January 25, 2022 Category: Endocrinology Source Type: research
Type 2 Diabetes, Glycemic Control, and Their Association With Dementia and Its Major Subtypes: Findings From the Swedish National Diabetes Register
CONCLUSIONSThe association of type 2 diabetes with dementia differs by subtypes of dementia. The strongest detrimental association is observed for vascular dementia. Moreover, patients with type 2 diabetes with poor glycemic control have an increased risk of developing vascular and nonvascular dementia. (Source: Diabetes Care)
Source: Diabetes Care - January 25, 2022 Category: Endocrinology Source Type: research
Real-world Evidence of Efficacy and Safety of SGLT2 Inhibitors as Adjunctive Therapy in Adults With Type 1 Diabetes: A European Two-Center Experience
CONCLUSIONSOur real-world data on SGLT2i showed promising results in reductions in HbA1c, weight, and insulin requirements in type 1 diabetes. Benefits were more pronounced in individuals with higher baseline HbA1c and BMI. DKA remained a major concern, despite educational measures. Further real-life evidence is still required for evaluation of SGLT2i longer-term effects and their impact on reno-cardiovascular outcomes. (Source: Diabetes Care)
Source: Diabetes Care - January 21, 2022 Category: Endocrinology Source Type: research
