Practical Diabetes最新文献

{"title":"Teeth and gums in diabetes","authors":"R. Hillson","doi":"10.1002/pdi.2422","DOIUrl":"https://doi.org/10.1002/pdi.2422","url":null,"abstract":"","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77645271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faricimab for treatment of diabetic macular oedema","authors":"Adriana Kovacova","doi":"10.1002/pdi.2423","DOIUrl":"https://doi.org/10.1002/pdi.2423","url":null,"abstract":"8 PRACTICAL DIABETES Vol. 39 No. 6 Copyright © 2022 John Wiley & Sons D macular oedema (DME) is a common cause of sight impairment in people with diabetes. Twentyseven percent of people with type 1 diabetes develop DME within nine years of the disease onset.1 For people with type 2 diabetes, 25.4% of insulin dependent and 13.9% of those who do not use insulin have DME.2 Alarmingly, diabetes is estimated to increase by 56% in the United States by 2030, with DME causing visual impairment in up to 25% of patients.2 Given the current therapeutic options, there is a strong need for innovative drugs designed to reduce treatment burden by improved efficacy and durability.3–5 NICE recently approved faricimab (Vabysmo), a novel bispecific monoclonal antibody designed for the intravitreal treatment of diabetic eye disease.6 By targeting both vascular endothelial growth factor A (VEGF-A) and the angiopoietin–tyrosine kinase endothelial receptors pathway (Ang/ Tie pathway) it displays an improved and sustained efficacy over longer treatment intervals, delivering superior vision outcomes and reducing the treatment burden.7,8 DME is the accumulation of excess fluid within the central area of the retina, called the macula. Risk factors include duration of diabetes, elevated HbA1c, hypertension, hyperlipidaemia, impaired renal function and the use of thiazolidinediones.9 DME usually causes distorted and blurred vision and creates difficulty especially with detailed tasks such as reading, watching television, driving and recognising faces. It gets diagnosed by a combination of clinical examination (dilated fundoscopy) and optical coherence tomography. The treatment of DME is systemic involving optimising control of diabetes, blood pressure and lipid profile as well as cessation of smoking. In addition, ophthalmic treatments are often indicated. Retinal laser has been conventionally used to treat macular thickening not directly involving the central vision.10 Fovea involving DME is managed by two main classes of intravitreal medication: anti-VEGF injections and steroid implants.4,9,11–13 Discovery of the VEGF pathway has facilitated treatments that are currently being used as mainstay of care in DME sufferers. Vascular endothelial growth factors (VEGFs) are a family of cytokines, that are involved in the process of angiogenesis. They function as signal proteins that bind with their respective transmembrane tyrosine kinase receptors (VEGFR) leading to proliferation of endothelial cells and growth of new blood vessels from existing vasculature. There are five main isoforms in the VEGF family: VEGF A–D and placental growth factor (PIGF). In patients with DME, VEGF levels are upregulated – in particular VEGF-A levels, a key component in pathological neoangiogenesis and vascular permeability.7,14,15 Anti-VEGF agents are engineered humanised antibodies that block the effects of VEGF on the leaking capillaries in DME, therefore ‘dry up’ the macula. Anti-VEGF ranibizumab ","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90449867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide and type 1 diabetes: a complex issue","authors":"Katharine Barnard-Kelly, R. Holt, S. O’Neill","doi":"10.1002/pdi.2413","DOIUrl":"https://doi.org/10.1002/pdi.2413","url":null,"abstract":"","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91185011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes, ethnic minority groups and COVID‐19: an inevitable storm","authors":"K. Khunti","doi":"10.1002/pdi.2414","DOIUrl":"https://doi.org/10.1002/pdi.2414","url":null,"abstract":"The risk of type 2 diabetes (T2DM) is two‐ to four‐fold higher in ethnic minority populations compared to White populations in the UK and is also associated with an increased risk of certain macrovascular and microvascular complications. Additionally, T2DM has an earlier onset in ethnic minority groups of around 10–12 years than in White populations. The exact reasons for the higher prevalence are unclear but include the complex interplay of biological, lifestyle, environmental and socioeconomic factors. This is further compounded by disparities in care received by ethnic minority populations. The UK was the first country to report on the disproportionate impact of COVID‐19 on ethnic minority groups. Diabetes is also a major risk factor for severe COVID‐19 and, combined with pre‐existing ethnic disparities in diabetes care, has been a significant contributor to inequalities in COVID‐19 outcomes for ethnic minority populations with diabetes including disproportionate hospitalisation and mortality. Major ethnic disparities in diabetes care in the US and UK, especially intermediate outcomes and diabetes complications, were evident prior to the COVID‐19 pandemic. However, the COVID‐19 pandemic has exposed these pre‐pandemic health disparities for ethnic minority populations with diabetes. Similar to the higher risk of T2DM in ethnic minority populations, the exact reasons for higher risk of COVID‐19 in minority ethnic groups are complex and include comorbidities, risk factor control, deprivation and access to care including wider structural issues. As we now plan for recovery, it is imperative that those delivering diabetes care urgently address the disproportionate impact the pandemic has had on ethnic minority populations. Reducing these inequalities will require a greater understanding of the causes. Copyright © 2022 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75056754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key updates to the management of type 2 diabetes in adults: how to embrace and embed the new NICE guidance","authors":"N. Basudev","doi":"10.1002/pdi.2412","DOIUrl":"https://doi.org/10.1002/pdi.2412","url":null,"abstract":"","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80997995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are guidelines a help or a hindrance?","authors":"J. Ogden","doi":"10.1002/pdi.2417","DOIUrl":"https://doi.org/10.1002/pdi.2417","url":null,"abstract":"The question of whether or not updated guidelines are a help or hindrance in clinical practice formed the focus of the June 2022 Trend Diabetes Nursing Conference held in London and Birmingham. Joy Ogden here reports on conference highlights examining this and other crucial considerations in the care of people with diabetes.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81324047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting it right first time – precision medicine in diabetes","authors":"A. Kilvert, C. Fox","doi":"10.1002/pdi.2419","DOIUrl":"https://doi.org/10.1002/pdi.2419","url":null,"abstract":"Precision medicine – ‘The right therapy for the right patient at the right time – every time’ – has been a hot topic over the past few years. The definition refers not just to treatment but also to diagnosis, prevention and prognosis. The evidence base for precision medicine is drawn from three categories: (i) assessment of the genetic and metabolic state; (ii) interrogation of big data to inform disease categories; (iii) science‐guided preventative and treatment decisions.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84506493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and outcomes of severe hypoglycaemia requiring hospital admission: a retrospective study","authors":"Alison Galea, Stephanie Farrugia, N. Calleja, D. Coppini","doi":"10.1002/pdi.2415","DOIUrl":"https://doi.org/10.1002/pdi.2415","url":null,"abstract":"This is a retrospective study intended to determine the prevalence of severe hypoglycaemia requiring admission to Mater Dei Hospital from January to December 2018. We identified risk factors associated with hospital admission and conducted a survival analysis of the cohort.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88526436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tropical medicine and diabetes: an integrative paradigm","authors":"J. Seewoodhary, Rodrigo Ville Benavides, Ângela Silveira","doi":"10.1002/pdi.2420","DOIUrl":"https://doi.org/10.1002/pdi.2420","url":null,"abstract":"Recent advances in public health and preventative medicine have significantly changed the epidemiology of disease in the tropics this century. Tropical medicine has transitioned away from being a specialty honed exclusively on infectious disease to now encompassing the management and relationship of infectious diseases with increasingly prevalent non‐communicable diseases, such as diabetes mellitus, in lower‐ and middle‐income countries. This review will critically consider unique aspects of diabetes care in the tropics. Copyright © 2022 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88910074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenges of managing type 1 diabetes with other autoimmune diseases","authors":"Mohammed Salloum, R. Poole","doi":"10.1002/pdi.2418","DOIUrl":"https://doi.org/10.1002/pdi.2418","url":null,"abstract":"People with type 1 diabetes have an increased risk of developing other autoimmune diseases compared to the background population and this risk has been increasing over the last 20 years. Coeliac disease affects absorption of food which can lead to hypoglycaemia in people with diabetes. Both conditions have dietary restrictions and managing the two can make food choices more difficult. Addison's disease can lead to significant challenges in managing blood glucose particularly in times of intercurrent illness and significantly increases morbidity and mortality in patients with diabetes. Thyroid disease, both hyperthyroidism (Graves’ disease) and hypothyroidism (Hashimoto's thyroiditis) can affect blood glucose levels directly by changes in glucose uptake and metabolism or indirectly through changes in weight. Management of type 1 diabetes includes being alert to the possibility of these potential additional diagnoses. Copyright © 2022 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84195086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}