Controversies Around the Measurement of Blood Ketones to Diagnose and Manage Diabetic Ketoacidosis
This article provides a perspective on these topics to complement current recommendations and to suggest how future research may improve its use in the DKA context. (Source: Diabetes Care)
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Response to Comment on Lee et al. Sodium –Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score–Matched Cohort Study. Diabetes Care 2021; 44:2419–2426
We would like to thank Feldman-Billard and Paques (1) for their interest in our article (2) and for expressing their concern that our findings could raise an overabundance of caution about the risk of retinal vein occlusion (RVO) associated with the new use of sodium –glucose cotransporter 2 (SGLT2) inhibitors in elderly patients with chronic kidney disease (CKD). (Source: Diabetes Care)
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Comment on Meek et al. Reappearance of C-Peptide During the Third Trimester of Pregnancy in Type 1 Diabetes: Pancreatic Regeneration or Fetal Hyperinsulinism? Diabetes Care 2021;44:1826 –1834
We read with interest the article by Meek et al. (1). The authors have measured maternal serum C-peptide concentrations at 12, 24, and 34 weeks of gestation in 127 pregnant women with type 1 diabetes and cord blood C-peptide concentrations. In 74 (58%) pregnant women, C-peptide was not detected; in 22 (17%), it was confirmed at the beginning of pregnancy; and in 31 (24%), it was detected in the 34th week of pregnancy (1). Neonates born to mothers in whom C-peptide was detected at 34 weeks of gestation had elevated cord blood C-peptide and more frequent neonatal complications than others (1). Based on the results, the autho...
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Comment on Ipp and Kumar. A Clinical Conundrum: Intensifying Glucose Control in the Presence of Advanced Diabetic Retinopathy. Diabetes Care 2021;44:2192 –2193
We were interested by the recent article from Ipp and Kumar (1), who questioned whether we should slow down glycemic normalization in subjects with type 2 diabetes and advanced retinopathy due to the recent report from the Veterans Affairs Diabetes Trial (VADT) (2). Diabetic retinopathy is a strong predictor of other complications, such as cardiovascular events (3) and lower extremity arterial disease (4), and we wondered whether a quick decline of HbA1c relates to their occurrence. (Source: Diabetes Care)
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Response to Comment on Meek et al. Reappearance of C-Peptide During the Third Trimester in Type 1 Diabetes Pregnancy: Pancreatic Regeneration or Fetal Hyperinsulinism? Diabetes Care 2021;44:1826 –1834
We read with interest the letter and study synopsis from Ivanisevic and Djelmis (1) and published descriptions (n = ∼30) of their cohort of pregnant women with type 1 diabetes (T1D) (2). It is unclear how many of their participants had detectable C-peptide at baseline. Typically,<50% of women with T1D have detectable C-peptide in early pregnancy, suggesting residual β-cell function (3). (Source: Diabetes Care)
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Comment on Lee et al. Sodium –Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score–Matched Cohort Study. Diabetes Care 2021;44:2419–2426
We read with great interest the article by Lee et al. (1) showing an increased risk of retinal vein occlusion (RVO) among patients with diabetes initiating sodium –glucose cotransporter 2 inhibitors (SGLT2i) based on a very large Korean cohort. (Source: Diabetes Care)
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Response to Comment on Ipp and Kumar. A Clinical Conundrum: Intensifying Glucose Control in the Presence of Advanced Diabetic Retinopathy. Diabetes Care 2021;44:2192 –2193
Rigalleau et al. (1) provide interesting findings from their observational follow-up study of long-term sequelae of type 2 diabetes that suggest rapid reduction in A1C (>1.5% in less than 4 months) is associated with significant worsening in diabetic retinopathy (DR), cardiovascular events, and foot ulcers, with notably high hazard ratios (38.74, 3.34, and 7.03, respectively). After this early and considerable decrease of A1C (mean 3.1%), these events presumably occurred over the ensuing mean 54 months of follow-up of their study. The comparator group had a stable A1C (although “stable” was not defined) and was not ...
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Comment on Khunti et al. COVID-19, Hyperglycemia, and New-Onset Diabetes. Diabetes Care 2021;44:2645 –2655
An uncommon increased incidence of new-onset diabetes has been observed in patients with coronavirus disease 2019 (COVID-19) (1). The recent interesting article by Khunti et al. (1) has summarized the potential mechanisms for newly diagnosed diabetes associated with COVID-19; in addition, they gave recommendations for the management of patients with diabetes associated with COVID-19 and suggestions for future research (1). Even if the precise mechanisms of new-onset diabetes in people with COVID-19 are not fully understood at the moment, several processes, such as previously undiagnosed diabetes, stress hyperglycemia, ster...
Source: Diabetes Care - January 17, 2022 Category: Endocrinology Source Type: research

Continuous Glucose Monitoring Initiation Within First Year of Type 1 Diabetes Diagnosis Is Associated With Improved Glycemic Outcomes: 7-Year Follow-Up Study
CONCLUSIONSCGM initiation within first year of type 1 diabetes diagnosis results in long-term improvement in A1c. (Source: Diabetes Care)
Source: Diabetes Care - January 12, 2022 Category: Endocrinology Source Type: research

Erratum. Comment on Choi et al. Alcohol Abstinence and the Risk of Atrial Fibrillation in Patients With Newly Diagnosed Type 2 Diabetes Mellitus: A Nationwide Population-Based Study. Diabetes Care 2021;44:1393 –1401
In the above-referenced article, for author Gwo-Ping Jong, the affiliation “School of Pharmacy, National Defense Medical Center, Taipei, Taiwan” was incorrect and the affiliation “Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan” was incomplete. The author’s correct affiliation is “Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung, Taiwan.” (Source: Diabetes Care)
Source: Diabetes Care - January 12, 2022 Category: Endocrinology Source Type: research

Erratum. Rationale and Design of the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care 2013;36:2254 –2261
The article cited above outlines the details of the then-upcoming Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) clinical trial, but it was not linked to the GRADEClinicalTrials.gov identifier. The GRADEClinicalTrials.gov identifier isNCT01794143. (Source: Diabetes Care)
Source: Diabetes Care - January 12, 2022 Category: Endocrinology Source Type: research

Erratum. Characteristics of the Gut Microbiota and Metabolism in Patients With Latent Autoimmune Diabetes in Adults: A Case-Control Study. Diabetes Care 2021;44:2738 –2746
In the above-cited article, the numbers of patients with classic type 1 diabetes and patients with type 2 diabetes were inadvertently given as 31 and 30, respectively, in the abstract and main article text. The correct number of patients with classic type 1 diabetes is 29, and correct number of patients with type 2 diabetes is 31. (Source: Diabetes Care)
Source: Diabetes Care - January 12, 2022 Category: Endocrinology Source Type: research

Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial
CONCLUSIONSIncreased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes. (Source: Diabetes Care)
Source: Diabetes Care - January 12, 2022 Category: Endocrinology Source Type: research

Genetic Risk Score Enhances Coronary Artery Disease Risk Prediction in Individuals With Type 1 Diabetes
CONCLUSIONSA GRS identified individuals at high risk of CAD and worked better in younger individuals. GRS was also an independent risk factor for CAD, with a predictive power comparable to that of HbA1c and HDL and total cholesterol, and when incorporated into a clinical model, modestly improved the predictions. The GRS promises early risk stratification in clinical practice by enhancing the prediction of CAD. (Source: Diabetes Care)
Source: Diabetes Care - January 12, 2022 Category: Endocrinology Source Type: research

Early Trajectory of Estimated Glomerular Filtration Rate and Long-term Advanced Kidney and Cardiovascular Complications in Type 1 Diabetes
CONCLUSIONSIn people with type 1 diabetes primarily with normal eGFR and normoalbuminuria, the preceding slope of eGFR confers no additional association with kidney or cardiovascular outcomes beyond knowledge of an individual ’s current level. (Source: Diabetes Care)
Source: Diabetes Care - January 11, 2022 Category: Endocrinology Source Type: research