Pub Date : 2024-06-14DOI: 10.1016/j.jdiacomp.2024.108799
Zsolt Hermányi , Adrienn Menyhárt , Anna Erzsébet Körei , Ildikó Istenes , Genevieve Arany Lao-kan , Vanda Csiki , Abdallah Benhamida , Miklos Kozlovszky , Attila Berey , Peter Markovich , Péter Kempler
Aims
Our study examined changes in average blood glucose levels (ABG), measurement frequency (MF), and data uploading (DU) before and during the COVID-19 pandemic in 882-day spans, which were divided into further 20-week intervals to highlight the pandemic's impact.
Methods
T-Tests assessed the statistical significance of blood glucose data from 26,655/20,936 patients and 19.5/16.6 million records during pre-COVID/COVID.
Results
During COVID, patients had significantly lower ABG levels (9.1/8.9 mmol/L, p < 0.001). Weekly DU decreased (155,945/128,445, p < 0.05), while daily MF increased (0.83/0.87, p < 0.001). Comparing the last 20 weeks pre-COVID to the first 20 weeks during COVID, ABG levels were lower (9.0 /8.9, p < 0.01), MF increased (0.83 /0.99, p < 0.001), and DU decreased (153,133/145,381, p < 0.05). In the initial 20 weeks of COVID compared to the second 20 weeks of COVID, ABG increased (8.9/9.1, p < 0.01), MF decreased (0.99/0.95, p < 0.001), and DU decreased (145,381/140,166, p < 0.05). Our most striking observation was the temporary dramatic fall in glucose uploads during the first few weeks of COVID. The changes of ABG and MF values were statistically significant, but were not deemed clinically relevant.
Conclusions
Despite COVID's prolonged impact, diabetic patients showed improved attitudes. A significant drop in data uploads occurred during the first 20 weeks of COVID; home office and lockdowns apparently disrupted patient routines.
{"title":"A comprehensive analysis of diabetic patient data before and during the COVID-19 pandemic – Lessons from the MÉRY diabetes database (MDD)","authors":"Zsolt Hermányi , Adrienn Menyhárt , Anna Erzsébet Körei , Ildikó Istenes , Genevieve Arany Lao-kan , Vanda Csiki , Abdallah Benhamida , Miklos Kozlovszky , Attila Berey , Peter Markovich , Péter Kempler","doi":"10.1016/j.jdiacomp.2024.108799","DOIUrl":"10.1016/j.jdiacomp.2024.108799","url":null,"abstract":"<div><h3>Aims</h3><p>Our study examined changes in average blood glucose levels (ABG), measurement frequency (MF), and data uploading (DU) before and during the COVID-19 pandemic in 882-day spans, which were divided into further 20-week intervals to highlight the pandemic's impact.</p></div><div><h3>Methods</h3><p><em>T</em>-Tests assessed the statistical significance of blood glucose data from 26,655/20,936 patients and 19.5/16.6 million records during pre-COVID/COVID.</p></div><div><h3>Results</h3><p>During COVID, patients had significantly lower ABG levels (9.1/8.9 mmol/L, <em>p</em> < 0.001). Weekly DU decreased (155,945/128,445, <em>p</em> < 0.05), while daily MF increased (0.83/0.87, p < 0.001). Comparing the last 20 weeks pre-COVID to the first 20 weeks during COVID, ABG levels were lower (9.0 /8.9, <em>p</em> < 0.01), MF increased (0.83 /0.99, p < 0.001), and DU decreased (153,133/145,381, p < 0.05). In the initial 20 weeks of COVID compared to the second 20 weeks of COVID, ABG increased (8.9/9.1, p < 0.01), MF decreased (0.99/0.95, p < 0.001), and DU decreased (145,381/140,166, p < 0.05). Our most striking observation was the temporary dramatic fall in glucose uploads during the first few weeks of COVID. The changes of ABG and MF values were statistically significant, but were not deemed clinically relevant.</p></div><div><h3>Conclusions</h3><p>Despite COVID's prolonged impact, diabetic patients showed improved attitudes. A significant drop in data uploads occurred during the first 20 weeks of COVID; home office and lockdowns apparently disrupted patient routines.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We sought to determine whether treatment with tirzepatide in type 2 diabetes mellitus (T2DM) patients can increase the odds for achieving normoglycemia, compatible with glycated hemoglobin levels lower than 5.7 %. We demonstrated that treatment with tirzepatide versus control increased the odds for achievement of normoglycemia by >16 times.
{"title":"Achievement of normoglycemia with tirzepatide in type 2 diabetes mellitus: A step closer to drug-induced diabetes remission?","authors":"Djordje S. Popovic , Dimitrios Patoulias , Theocharis Koufakis , Konstantinos Stavropoulos , Paschalis Karakasis , Ieva Ruža , Nikolaos Papanas , Manfredi Rizzo , Michael Doumas","doi":"10.1016/j.jdiacomp.2024.108800","DOIUrl":"10.1016/j.jdiacomp.2024.108800","url":null,"abstract":"<div><p>We sought to determine whether treatment with tirzepatide in type 2 diabetes mellitus (T2DM) patients can increase the odds for achieving normoglycemia, compatible with glycated hemoglobin levels lower than 5.7 %. We demonstrated that treatment with tirzepatide versus control increased the odds for achievement of normoglycemia by >16 times.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-13DOI: 10.1016/j.jdiacomp.2024.108798
Daniel Gottlieb , Layla A. Abushamat , Kristen J. Nadeau , Judith G. Regensteiner , Jane E.B. Reusch , Kalie L. Tommerdahl , John Rice , Leslie A. Knaub , Cynthia M.F. Monaco , Thomas J. Hawke , Christopher G.R. Perry , Melanie G. Cree , Irene E. Schauer
Aims
Type 1 diabetes has been associated with mitochondrial dysfunction. However, the mechanism of this dysfunction in adults remains unclear.
Methods
A secondary analysis was conducted using data from several clinical trials measuring in-vivo and ex-vivo mitochondrial function in adults with type 1 diabetes (n = 34, age 38.8 ± 14.6 years) and similarly aged controls (n = 59, age 44.6 ± 13.9 years). In-vivo mitochondrial function was assessed before, during, and after isometric exercise with 31phosphorous magnetic resonance spectroscopy. High resolution respirometry of vastus lateralis muscle tissue was used to assess ex-vivo measures.
Results
In-vivo data showed higher rates of anaerobic glycolysis (p = 0.013), and a lower maximal mitochondrial oxidative capacity (p = 0.012) and mitochondrial efficiency (p = 0.024) in adults with type 1 diabetes. After adjustment for age and percent body fat maximal mitochondrial capacity (p = 0.014) continued to be lower and anaerobic glycolysis higher (p = 0.040) in adults with type 1 diabetes. Ex-vivo data did not demonstrate significant differences between the two groups.
Conclusions
The in-vivo analysis demonstrates that adults with type 1 diabetes have mitochondrial dysfunction. This builds on previous research showing in-vivo mitochondrial dysfunction in youths with type 1 diabetes and suggests that defects in substrate or oxygen delivery may play a role in in-vivo dysfunction.
{"title":"Muscle mitochondrial function is impaired in adults with type 1 diabetes","authors":"Daniel Gottlieb , Layla A. Abushamat , Kristen J. Nadeau , Judith G. Regensteiner , Jane E.B. Reusch , Kalie L. Tommerdahl , John Rice , Leslie A. Knaub , Cynthia M.F. Monaco , Thomas J. Hawke , Christopher G.R. Perry , Melanie G. Cree , Irene E. Schauer","doi":"10.1016/j.jdiacomp.2024.108798","DOIUrl":"10.1016/j.jdiacomp.2024.108798","url":null,"abstract":"<div><h3>Aims</h3><p>Type 1 diabetes has been associated with mitochondrial dysfunction. However, the mechanism of this dysfunction in adults remains unclear.</p></div><div><h3>Methods</h3><p>A secondary analysis was conducted using data from several clinical trials measuring <em>in-vivo</em> and <em>ex-vivo</em> mitochondrial function in adults with type 1 diabetes (<em>n</em> = 34, age 38.8 ± 14.6 years) and similarly aged controls (<em>n</em> = 59, age 44.6 ± 13.9 years). <em>In-vivo</em> mitochondrial function was assessed before, during, and after isometric exercise with <sup>31</sup>phosphorous magnetic resonance spectroscopy. High resolution respirometry of vastus lateralis muscle tissue was used to assess <em>ex-vivo</em> measures.</p></div><div><h3>Results</h3><p><em>In-vivo</em> data showed higher rates of anaerobic glycolysis (<em>p</em> = 0.013), and a lower maximal mitochondrial oxidative capacity (<em>p</em> = 0.012) and mitochondrial efficiency (<em>p</em> = 0.024) in adults with type 1 diabetes. After adjustment for age and percent body fat maximal mitochondrial capacity (<em>p</em> = 0.014) continued to be lower and anaerobic glycolysis higher (<em>p</em> = 0.040) in adults with type 1 diabetes. <em>Ex-vivo</em> data did not demonstrate significant differences between the two groups.</p></div><div><h3>Conclusions</h3><p>The <em>in-vivo</em> analysis demonstrates that adults with type 1 diabetes have mitochondrial dysfunction. This builds on previous research showing <em>in-vivo</em> mitochondrial dysfunction in youths with type 1 diabetes and suggests that defects in substrate or oxygen delivery may play a role in <em>in-vivo</em> dysfunction.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141389839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.1016/S1056-8727(24)00114-4
{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(24)00114-4","DOIUrl":"https://doi.org/10.1016/S1056-8727(24)00114-4","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724001144/pdfft?md5=1ba4db3dc7b7216a939565b8b1a1b027&pid=1-s2.0-S1056872724001144-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141313159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.1016/j.jdiacomp.2024.108795
Ana Munda , Chiara Kovacic , Drazenka Pongrac Barlovic
Aim
The efficacy of hybrid closed-loop systems (HCLs) in managing glycemic control in pregnant women with type 1 diabetes remains inadequately characterized. We evaluated the use of the Medtronic Minimed 780G HCLs.
Methods
The retrospective observational study analyzed the glycemic and perinatal outcomes of pregnant women using the HCLs, followed at our tertiary centre. Independent t-tests were employed to compare data among trimesters based on pre-pregnancy HbA1c. The associations between glycemic parameters and perinatal outcomes were explored using Spearman rho.
Results
Among the 21 women (age: 33.5 ± 4.2 years, diabetes duration: 21.2 ± 7.6 years, pre-pregnancy HbA1c 7.0 ± 1.1 % (52.9 ± 11.9 mmol/mol)) time in range (pTIR, 63–140 mg/dl; 3.5–7.8 mmol/l) increased progressively throughout pregnancy (trimesters: first: 64.0 ± 9.0 %; second:71.3 ± 11.8 %; third: 75.7 ± 8.1 %). Simultaneously, mean sensor glucose decreased (trimesters: first: 130 ± 10.4 mg/dl (7.2 ± 0.6 mmol/l); second: 120.9 ± 13.4 mg/dl (6.7 ± 0.7 mmol/l); third: 117.3 ± 9.1 mg/dl (6.5 ± 0.5 mmol/l)). Although a majority of women achieved the target pTIR until the third trimester, this did not consistently prevent the delivery of a large-for-gestational-age baby. Notably, one ketoacidosis event occurred, and there were no reported instances of severe hypoglycemia.
Conclusion
Use of the Minimed 780G HCLs enabled the attainment of recommended pregnancy glycemic targets for most women with type 1 diabetes in a real-world setting.
{"title":"Real-world data on the Minimed 780G advanced hybrid closed-loop system use during type 1 diabetes pregnancy: One centre observational study","authors":"Ana Munda , Chiara Kovacic , Drazenka Pongrac Barlovic","doi":"10.1016/j.jdiacomp.2024.108795","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108795","url":null,"abstract":"<div><p>Aim</p><p>The efficacy of hybrid closed-loop systems (HCLs) in managing glycemic control in pregnant women with type 1 diabetes remains inadequately characterized. We evaluated the use of the Medtronic Minimed 780G HCLs.</p></div><div><h3>Methods</h3><p>The retrospective observational study analyzed the glycemic and perinatal outcomes of pregnant women using the HCLs, followed at our tertiary centre. Independent <em>t</em>-tests were employed to compare data among trimesters based on pre-pregnancy HbA<sub>1c</sub>. The associations between glycemic parameters and perinatal outcomes were explored using Spearman rho.</p></div><div><h3>Results</h3><p>Among the 21 women (age: 33.5 ± 4.2 years, diabetes duration: 21.2 ± 7.6 years, pre-pregnancy HbA<sub>1c</sub> 7.0 ± 1.1 % (52.9 ± 11.9 mmol/mol)) time in range (pTIR, 63–140 mg/dl; 3.5–7.8 mmol/l) increased progressively throughout pregnancy (trimesters: first: 64.0 ± 9.0 %; second:71.3 ± 11.8 %; third: 75.7 ± 8.1 %). Simultaneously, mean sensor glucose decreased (trimesters: first: 130 ± 10.4 mg/dl (7.2 ± 0.6 mmol/l); second: 120.9 ± 13.4 mg/dl (6.7 ± 0.7 mmol/l); third: 117.3 ± 9.1 mg/dl (6.5 ± 0.5 mmol/l)). Although a majority of women achieved the target pTIR until the third trimester, this did not consistently prevent the delivery of a large-for-gestational-age baby. Notably, one ketoacidosis event occurred, and there were no reported instances of severe hypoglycemia.</p></div><div><h3>Conclusion</h3><p>Use of the Minimed 780G HCLs enabled the attainment of recommended pregnancy glycemic targets for most women with type 1 diabetes in a real-world setting.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141325027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.1016/j.jdiacomp.2024.108794
Laura Porterfield , Xiaoying Yu , Victoria Warren , Michael E. Bowen , Carolyn Smith-Morris , Elizabeth M. Vaughan
Aims
Conduct a secondary analysis of the TIME (Telehealth-supported, Integrated Community Health Workers (CHWs), Medication access, diabetes Education) made simple trial (SIMPLE) to evaluate healthcare utilization and explore variables that may have influenced HbA1c.
Methods
Participants (N = 134 [67/group]) were low-income, uninsured Hispanics with or at risk for type 2 diabetes mellitus. We included in-person and telehealth clinician visits, other visits, missed visits, orders placed, and guideline-adherence (e.g., vaccinations, quarterly HbA1c for uncontrolled diabetes). Using multivariable models, we explored for associations between HbA1c changes and these measures.
Results
The control arm had higher missed visits rates (intervention: 45 %; control: 56 %; p = 0.007) and missed telehealth appointments (intervention: 10 %; control: 27.4 %; p = 0.04). The intervention group received more COVID vaccinations than the control (p = 0.005). Other health measures were non-significant between groups. Intervention individuals' HbA1c improved with more missed visits (−0.60 %; p < 0.01) and worsened with improved guideline-adherent HbA1c measurements (HbA1c: 1.2 %; p = 0.057). The control group had non-significant HbA1c associations.
Conclusions
Findings suggest that the SIMPLE trial's improved HbA1c levels stemmed from a CHW-driven intervention and not additional healthcare contact. Exploratory outcomes resulted in seemingly counterintuitive HbA1c associations with missed visits and guideline-adherent measurements; these may suggest that an intervention that enhances communication provides support to reduce the amount of follow-up needed by participants without sacrificing clinical improvements.
{"title":"A community health worker led diabetes self-management education program: Reducing patient and system burden","authors":"Laura Porterfield , Xiaoying Yu , Victoria Warren , Michael E. Bowen , Carolyn Smith-Morris , Elizabeth M. Vaughan","doi":"10.1016/j.jdiacomp.2024.108794","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108794","url":null,"abstract":"<div><h3>Aims</h3><p>Conduct a secondary analysis of the <em>TIME</em> (Telehealth-supported, Integrated Community Health Workers (CHWs), Medication access, diabetes Education) <em>made simple</em> trial (SIMPLE) to evaluate healthcare utilization and explore variables that may have influenced HbA1c.</p></div><div><h3>Methods</h3><p>Participants (<em>N</em> = 134 [67/group]) were low-income, uninsured Hispanics with or at risk for type 2 diabetes mellitus. We included in-person and telehealth clinician visits, other visits, missed visits, orders placed, and guideline-adherence (e.g., vaccinations, quarterly HbA1c for uncontrolled diabetes). Using multivariable models, we explored for associations between HbA1c changes and these measures.</p></div><div><h3>Results</h3><p>The control arm had higher missed visits rates (intervention: 45 %; control: 56 %; <em>p</em> = 0.007) and missed telehealth appointments (intervention: 10 %; control: 27.4 %; <em>p</em> = 0.04). The intervention group received more COVID vaccinations than the control (<em>p</em> = 0.005). Other health measures were non-significant between groups. Intervention individuals' HbA1c improved with more missed visits (−0.60 %; <em>p</em> < 0.01) and worsened with improved guideline-adherent HbA1c measurements (HbA1c: 1.2 %; <em>p</em> = 0.057). The control group had non-significant HbA1c associations.</p></div><div><h3>Conclusions</h3><p>Findings suggest that the SIMPLE trial's improved HbA1c levels stemmed from a CHW-driven intervention and not additional healthcare contact. Exploratory outcomes resulted in seemingly counterintuitive HbA1c associations with missed visits and guideline-adherent measurements; these may suggest that an intervention that enhances communication provides support to reduce the amount of follow-up needed by participants without sacrificing clinical improvements.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.1016/j.jdiacomp.2024.108793
Joshua G. Kovoor , Christopher K. Rayner , Tongzhi Wu , Ryan J. Jalleh , Guy J. Maddern , Michael Horowitz , Karen L. Jones
Gastric emptying of a glucose drink was measured in people with type 2 diabetes given lixisenatide (20 μg/day or placebo) for 8 weeks. Intragastric retention at 240 min (2 (0−11)% vs 48 (3–97)%; P < 0.0001) was much greater with lixisenatide than placebo. Accordingly, lixisenatide may delay liquid gastric emptying markedly.
对服用利西那肽(20 微克/天或安慰剂)8 周的 2 型糖尿病患者进行了葡萄糖饮料胃排空测定。240分钟时的胃内滞留率(2 (0-11)% vs 48 (3-97)%; P < 0.0001)利西那肽远高于安慰剂。因此,利血那肽可明显延迟液态胃排空。
{"title":"Effect of lixisenatide on liquid gastric emptying in type 2 diabetes – Implications for the use of GLP-1 receptor agonists before procedures","authors":"Joshua G. Kovoor , Christopher K. Rayner , Tongzhi Wu , Ryan J. Jalleh , Guy J. Maddern , Michael Horowitz , Karen L. Jones","doi":"10.1016/j.jdiacomp.2024.108793","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108793","url":null,"abstract":"<div><p>Gastric emptying of a glucose drink was measured in people with type 2 diabetes given lixisenatide (20 μg/day or placebo) for 8 weeks. Intragastric retention at 240 min (2 (0−11)% vs 48 (3–97)%; <em>P</em> < 0.0001) was much greater with lixisenatide than placebo. Accordingly, lixisenatide may delay liquid gastric emptying markedly.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724001193/pdfft?md5=59e914b64633c07c93d231e8dba7b5e2&pid=1-s2.0-S1056872724001193-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141314511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.1016/j.jdiacomp.2024.108783
Anika Bilal , Fanchao Yi , Gonzalo Romero Gonzalez , Mehreen Ali , KyungAh Im , Christian T. Ruff , Tina K. Thethi , Richard E. Pratley
Aim
To demonstrate cardiovascular safety of dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and sodium/glucose cotransporter 2 inhibitors (SGLT-2i) across age-groups.
Methods
PubMed, Embase and Cochrane were searched for cardiovascular outcome trials (CVOTs) testing newer agents until August 31, 2022 (PROSPERO ID CRD42021260167). Studies with ≥1000 T2D participants enrolled for ≥12 months were included. Random effect models were used to report relative-risk (RR) for three-point major adverse cardiovascular events (3P-MACE) and its components by age subgroups (65 years; 75 years).
Results
For SGLT-2is, five CVOTs (46,969 patients, 45–50 % ≥65 years) were included. SGLT-2is reduced risk of MACE (RR; 0.91 [CI, 0.85–0.98]); cardiovascular death (CV-death) (RR; 0.84 [CI, 0.73–0.96]); and all-cause mortality (ACM) (RR; 0.86 [CI, 0.79–0.93]) with no difference in subgroups <65 or ≥65 years.
For GLP-1RAs, nine CVOTs (n = 64,236, 34–75 % ≥65 years) were included. GLP-1RAs reduced risk of MACE (RR; 0.89 [CI, 0.83–0.95]), stroke (RR; 0.86 [CI, 0.76–0.97]) and ACM (RR; 0.90 [CI, 0.83–0.97]) with no significant difference in subgroups <65 or ≥65 years. Additionally, GLP-1RAs reduced risk of MACE (10 %), ACM (12 %) and CV-death (12 %) with no significant difference in subgroups <75 or ≥75 years.
Four CVOTs (n = 33,063; 35–58 % ≥65 years) with DPP-4is were included. There were no significant differences in risk for CV outcomes with DPP-4is compared to placebo in any of the age subgroups.
Conclusion
The overall cardiovascular safety profile of newer anti-hyperglycemic agents is consistent in older and younger individuals.
{"title":"Effects of newer anti-hyperglycemic agents on cardiovascular outcomes in older adults: Systematic review and meta-analysis","authors":"Anika Bilal , Fanchao Yi , Gonzalo Romero Gonzalez , Mehreen Ali , KyungAh Im , Christian T. Ruff , Tina K. Thethi , Richard E. Pratley","doi":"10.1016/j.jdiacomp.2024.108783","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108783","url":null,"abstract":"<div><h3>Aim</h3><p>To demonstrate cardiovascular safety of dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and sodium/glucose cotransporter 2 inhibitors (SGLT-2i) across age-groups.</p></div><div><h3>Methods</h3><p>PubMed, Embase and Cochrane were searched for cardiovascular outcome trials (CVOTs) testing newer agents until August 31, 2022 (PROSPERO ID CRD42021260167). Studies with ≥1000 T2D participants enrolled for ≥12 months were included. Random effect models were used to report relative-risk (RR) for three-point major adverse cardiovascular events (3P-MACE) and its components by age subgroups (65 years; 75 years).</p></div><div><h3>Results</h3><p>For SGLT-2is, five CVOTs (46,969 patients, 45–50 % ≥65 years) were included. SGLT-2is reduced risk of MACE (RR; 0.91 [CI, 0.85–0.98]); cardiovascular death (CV-death) (RR; 0.84 [CI, 0.73–0.96]); and all-cause mortality (ACM) (RR; 0.86 [CI, 0.79–0.93]) with no difference in subgroups <65 or ≥65 years.</p><p>For GLP-1RAs, nine CVOTs (n = 64,236, 34–75 % ≥65 years) were included. GLP-1RAs reduced risk of MACE (RR; 0.89 [CI, 0.83–0.95]), stroke (RR; 0.86 [CI, 0.76–0.97]) and ACM (RR; 0.90 [CI, 0.83–0.97]) with no significant difference in subgroups <65 or ≥65 years. Additionally, GLP-1RAs reduced risk of MACE (10 %), ACM (12 %) and CV-death (12 %) with no significant difference in subgroups <75 or ≥75 years.</p><p>Four CVOTs (n = 33,063; 35–58 % ≥65 years) with DPP-4is were included. There were no significant differences in risk for CV outcomes with DPP-4is compared to placebo in any of the age subgroups.</p></div><div><h3>Conclusion</h3><p>The overall cardiovascular safety profile of newer anti-hyperglycemic agents is consistent in older and younger individuals.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141314510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-alcoholic fatty liver disease (NAFLD1) is the most frequent chronic liver disorder worldwide. Currently, no pharmacological treatment has been approved for NAFLD. Probiotics have been suggested as a potential therapy for NAFLD. The aim of this systematic review and meta-analysis was to assess the impact of probiotic intake on liver tests, lipids, glycemic parameters and inflammatory markers in NAFLD patients.
Methods
We searched electronic databases using related terms. Meta-analysis was performed using random-effects models. Clinical outcomes were presented as standard mean difference (SMD2) with a 95 % confidence interval (CI3). Publication bias and heterogeneity were evaluated in eligible studies.
Results
Fifteen randomized clinical trials comprising 899 participants were included in our meta-analysis. Probiotic supplementation improved alanine transaminase [SMD -0.796; 95 % CI (−1.419, −0.172); p = 0.012], Homeostatic Model Assessment for Insulin Resistance (HOMA-IR4) [SMD -0.596; 95 % CI (−1.071, −0.121); p = 0.01] and insulin levels [SMD -1.10; 95 % CI (−2.121, −0.087); p = 0.03]. No significant effects were observed on fasting glucose, hemoglobin A1c, aspartate transaminase, lipid profile, interleukin-6 and tumor necrosis factor-α.
Conclusions
Probiotic intake may improve insulin sensitivity and alanine transaminase in NAFLD patients.
{"title":"The effect of probiotic consumption on lipid profile, glycemic index, inflammatory markers, and liver function in NAFLD patients: A systematic review and meta-analysis of randomized controlled trials","authors":"Sadegh Mozaffari , Mahdeyeh Aliari , Solaleh Emamgholipour , Hossein Hosseini , Pedram Rezaei Amirkiasar , Mina Zare , Niki Katsiki , Ghodratollah Panahi , Amirhossein Sahebkar","doi":"10.1016/j.jdiacomp.2024.108780","DOIUrl":"10.1016/j.jdiacomp.2024.108780","url":null,"abstract":"<div><h3>Background-aim</h3><p>Non-alcoholic fatty liver disease (NAFLD<span><sup>1</sup></span>) is the most frequent chronic liver disorder worldwide. Currently, no pharmacological treatment has been approved for NAFLD. Probiotics have been suggested as a potential therapy for NAFLD. The aim of this systematic review and meta-analysis was to assess the impact of probiotic intake on liver tests, lipids, glycemic parameters and inflammatory markers in NAFLD patients.</p></div><div><h3>Methods</h3><p>We searched electronic databases using related terms. Meta-analysis was performed using random-effects models. Clinical outcomes were presented as standard mean difference (SMD<span><sup>2</sup></span>) with a 95 % confidence interval (CI<span><sup>3</sup></span>). Publication bias and heterogeneity were evaluated in eligible studies.</p></div><div><h3>Results</h3><p>Fifteen randomized clinical trials comprising 899 participants were included in our meta-analysis. Probiotic supplementation improved alanine transaminase [SMD -0.796; 95 % CI (−1.419, −0.172); <em>p</em> = 0.012], Homeostatic Model Assessment for Insulin Resistance (HOMA-IR<span><sup>4</sup></span>) [SMD -0.596; 95 % CI (−1.071, −0.121); p = 0.01] and insulin levels [SMD -1.10; 95 % CI (−2.121, −0.087); <em>p</em> = 0.03]. No significant effects were observed on fasting glucose, hemoglobin A1c, aspartate transaminase, lipid profile, interleukin-6 and tumor necrosis factor-α.</p></div><div><h3>Conclusions</h3><p>Probiotic intake may improve insulin sensitivity and alanine transaminase in NAFLD patients.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate early indicators of cardiovascular disease (CVD) in children and adolescents with type 1 diabetes mellitus (T1DM), focusing on pulse wave velocity (PWV) and its associations with various anthropometric and glycemic parameters.
Patients and methods
A total of 124 children and adolescents with T1D (mean age 10.75 ± 3.57 years) were included in this cross-sectional study. Anthropometric data, including height, weight, body mass index (BMI), glycemic parameters, such as HbA1c and time in range (TIR) were assessed. PWV was assessed by oscillometric method using the Mobil-O-Graph PWA device. Univariate and multivariate linear regression were used to explore the association of PWV z-score with anthropometric, demographic, and glycaemic variables.
Results
Significant negative association between PWV and age and height (β = −0.336, 95 % CI -0.44 to −0.25, p < 0.001 and β = −0.491, 95 % CI -0.62 to −0.36, p < 0.001, respectively), while gender showed a significant positive association with PWV, with females displaying higher PWV values compared to males (β = 0.366, 95 % CI 0.17 to 0.56, p < 0.001). TIR was positively associated with PWV (β = 0.092, 95 % CI 0.01 to 0.16, p = 0.017 only for patients having TIR ≤ 50 %. Finally, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were positively associated with PWV (β = 0.086, 95 % CI 0.02 to 0.14, p = 0.007 and β = 0.152, 95 % CI 0.07 to 0.23, p < 0.001, respectively).
Conclusion
Youth with T1DM who spend <50 % of time in range exhibit uniquely increased signs of arterial stiffness, indicating that poor glycemic control may contribute to early vascular damage. Differences related to age, gender and height should be considered.
{"title":"Assessment of arterial stiffness in paediatric patients with type 1 diabetes mellitus","authors":"Eirini Georeli , Athina Stamati , Meropi Dimitriadou , Athanasia Chainoglou , Assimina Galli Tsinopoulou , Stella Stabouli , Athanasios Christoforidis","doi":"10.1016/j.jdiacomp.2024.108782","DOIUrl":"10.1016/j.jdiacomp.2024.108782","url":null,"abstract":"<div><h3>Aims</h3><p>To investigate early indicators of cardiovascular disease (CVD) in children and adolescents with type 1 diabetes mellitus (T1DM), focusing on pulse wave velocity (PWV) and its associations with various anthropometric and glycemic parameters.</p></div><div><h3>Patients and methods</h3><p>A total of 124 children and adolescents with T1D (mean age 10.75 ± 3.57 years) were included in this cross-sectional study. Anthropometric data, including height, weight, body mass index (BMI), glycemic parameters, such as HbA1c and time in range (TIR) were assessed. PWV was assessed by oscillometric method using the Mobil-O-Graph PWA device. Univariate and multivariate linear regression were used to explore the association of PWV z-score with anthropometric, demographic, and glycaemic variables.</p></div><div><h3>Results</h3><p>Significant negative association between PWV and age and height (β = −0.336, 95 % CI -0.44 to −0.25, <em>p</em> < 0.001 and β = −0.491, 95 % CI -0.62 to −0.36, p < 0.001, respectively), while gender showed a significant positive association with PWV, with females displaying higher PWV values compared to males (β = 0.366, 95 % CI 0.17 to 0.56, <em>p</em> < 0.001). TIR was positively associated with PWV (β = 0.092, 95 % CI 0.01 to 0.16, <em>p</em> = 0.017 only for patients having TIR ≤ 50 %. Finally, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were positively associated with PWV (β = 0.086, 95 % CI 0.02 to 0.14, <em>p</em> = 0.007 and β = 0.152, 95 % CI 0.07 to 0.23, <em>p</em> < 0.001, respectively).</p></div><div><h3>Conclusion</h3><p>Youth with T1DM who spend <50 % of time in range exhibit uniquely increased signs of arterial stiffness, indicating that poor glycemic control may contribute to early vascular damage. Differences related to age, gender and height should be considered.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}