Adolescents & Young Adults - Managing the Co-occurring Life Challenges & Diabetes
Kellee M Miller diabetes paper highlighted that mean A1C's aren't even close to ADA's recommendations in Adolescents & Young Adults (AYA) with diabetes. AYA from regional, ethnic minorities and SCS backgrounds has higher mean A1C levels. Diabetes may also increase the risk for psychological problems in AYA. It is recommended to address the psychosocial needs of AYA with diabetes.
Remote Management of Diabetes Emergencies Using Telehealth
Remote telehealth can be effective for managing diabetes emergencies like hypoglycemia, hyperglycemia, and early diabetic ketoacidosis (DKA). Mobile apps and continuous ketone monitoring would add to the readiness of the healthcare system. This would allow clinicians to evaluate patients at risk of ketoacidosis.
Role of Adrenal Hormones in Type 2 Diabetes
Researchers investigated gene-driven physiology and population heterogeneity in the management of glucose metabolism. It was found that aldosterone is associated with higher insulin resistance, higher odds of prevalent diabetes and increased risk of diabetes over 10 years. Aldosterone could provide more structured and precise approaches to diabetes prevention and treatment.
Combinations for Type 2 Diabetes - Insulin and SGLT2 Inhibitors
The combination of Insulin & SGLT2i is a perfect match pathophysiologically owing to the suppression of glucagon and EGP levels. This combination could also provide better efficacy such as reducing HbA1c levels, insulin dose, weight gain, and hypoglycemia.
Association between health care coverage and glycemic control
Mean HbA1c values were similar for both types of diabetes in patients with public insurance. But a spike in blood glucose levels was observed in type 1 diabetes patients with no insurance. Concluding that healthcare coverage and access appeared to have a strong correlation with better glycemic control in adults with type 1 diabetes but the same cannot be said for adults with type 2 diabetes.
Safety Outcomes in Patients with and without Type 2 Diabetes
The clinical trials showed safety outcomes were consistent and the lab parameters were stable during hospitalization in patients treated with dapagliflozin and placebo regardless of their diabetes status. The values such as serum bicarbonate, eGFR, Hematocrit, Glucose levels all had a similar trajectory in patients with or without diabetes.
Triglycerides and Residual Atherosclerosis Risk
The study shows triglycerides are at the least a risk marker and likely risk enhancer for atherosclerotic cardiovascular disease even in low-risk persons who are not diabetic. In persons with low to moderate CV risk, hypertriglyceridemia was associated with subclinical atherosclerosis and vascular inflammation, even in those with normal LDL-C levels.
Venous and Arterial Thromboembolism in Patients With Cancer
Researchers examine the literature on venous and arterial thromboembolism in patients with cancer. Venous thromboembolism rates in cancer patients are 4-7 fold higher compared to healthy individuals, with approximately 15% of patients experiencing VTE. Conversely, 20% of unprovoked VTEs are the first sign of an underlying malignancy. The incidence of ATE was 4.7% in all patients with cancer.
Efficacy Outcomes in Patients with and without Type 2 Diabetes
The primary outcome of recovery showed similar results in patients on Dapagliflozin vs placebo with/without diabetes. The composite key endpoint: AKI, Initiation of renal replacement or all cause death. Patients on Dapagliflozin had fewer events than the placebo group and the outcome was 7.7% and 10.4% in patients on Dapagliflozin vs placebo. Results for all-cause mortality were also similar.
Significance of Aortic Branch Aneurysms in Patients with Marfan syndrome (MFS)
Aortic branch aneurysms were observed in one-quarter of patients with MFS, and the presence of these was independently associated with subsequent aortic surgery. The connective tissue abnormalities of MFS can result in abnormalities in the aortic branch vessels. However, the prevalence of aortic branch aneurysms is not established, and their clinical significance has not been clear.
Study Finds Cancer Increases Risk of AFib, But Varies Depending on Type of Cancer
Patients with cancer may be at higher risk for atrial fibrillation (AFib), although the impact on AFib development varies by cancer type. During a median follow-up of 4.5 years, AFib was diagnosed in 25,356 patients with cancer. Patients with multiple myeloma or esophageal cancer showed the highest risk of AFib, and those with stomach cancer had the lowest risk of AFib.
N-3 Polyunsaturated Fatty Acids for CVD: New Studies, Continued Debate
The beneficial effects of n-3 polyunsaturated fatty acids (PUFA) remain controversial due to disagreements over study design and choice of placebo. PUFA increases the rates of atrial fibrillation, emphasizing the importance of elucidating the true benefits of this class of medications. Despite the link, there remains debate about whether supplementation with PUFA improves cardiovascular outcomes.
Structural Grey Matter Alterations and Cognitive Function in Diabetes
A study compared the grey matter volume of participants with diabetes to those without diabetes. Peripheral cortical grey matter, superior frontal gyrus, right anterior and posterior division of the supramarginal gyrus, paracingulate gyrus, and precentral gyrus were lower in the diabetic group. Concluding decrease in global grey matter volume in specific brain regions of people with diabetes.
Liraglutide Is a Safe and Effective Treatment of Bile Acid Malabsorption
Excessive spill-over of bile acids to the colon causes Bile acid malabsorption (BAM). The only recommended treatment of BAM is Bile acid sequestrant (BAS). However, it has a poor effect and low compliance. A study shows that Liraglutide, a Glucagon-Like Peptide-1 Analog, enhances the reabsorption of bile acids and is safe and effective for the treatment of BAM.
Efficacy & Safety of Once-Weekly Efpeglenatide VS Placebo as Monotherapy in Patients with T2D
A Phase 3 study included patients who were unable to control type 2 diabetes with diet and exercise alone to evaluate the efficacy and safety of Efpeglenatide as a weekly subcutaneous treatment. Efpeglenatide showed significant reductions in HbA1c and body weight compared to placebo. However, it caused mild to moderate gastrointestinal adverse effects.
Clinical Implications of Semaglutide for Obesity Care
Semaglutide caused 2 times greater weight loss than liraglutide. In a 20 week trial, a dose of 2.4 mg Semaglutide per week with no lifestyle interventions resulted in up to 7% weight loss in adults with obesity. The superior efficacy demonstrates GLP-1 signaling is a powerful tool & effective target for obesity, providing a new opportunity to control obesity and its medical complications.
Hypoglycemia, Glycemic Variability & Cardiac Arrhythmia Risk in Insulin-Treated Patients with T2D
Implantable cardiac monitor (ICM) of Insulin-treated patients with T2D detected 724 episodes of clinically relevant arrhythmias in 57% of patients with atrial fibrillation. The incidence of cardiac arrhythmias during the night was directly proportional to the increasing glycemic variability. So arrhythmias in T2D patients on insulin were associated with glycemic variability, not hypoglycemia.
2012 Cardiac Resynchronization Therapy Guidelines Update - Reduced rates of heart Failure Hospital
The 2012 cardiac resynchronization therapy guidelines were modified to include left bundle branch block (LBBB) as a Class I indication for implant. HHF showed substantial reduction post update. Mortality alone was not substantially decreased. Presence of LBBB, history of previous device implant and implantation after guidelines were substantial multivariate predictors of reduced HHF risk.
High/Normal Carbohydrate Intake Optimises Performance and Glycemia
Consuming a high Carb diet after exercise increased the resting muscle glycogen concentration, a 13 g/Kg increase in a 36 hours period compared to a 3g/Kg in a low carb diet. A high CHO diet enhances endurance performance, cell signaling, gene expression, enzymatic changes, lipid oxidation and overall performance.
Association of Lipid Levels with COVID-19 Risk
The severity of COVID-19 infection and lipid levels outcomes shown by various studies suggests that an increased risk of death was inversely related to HDL C and apolipoproteins A1 Levels. Increased LDL C and apolipoproteins B levels were not associated with an increased risk of COVID-19 infections. While low HDL levels were linked to increased COVID-19 susceptibility.
