Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10307138
Natasha Meunier-McVey
THE 59th Annual Meeting of the European Association for the Study of Diabetes (EASD) took place in Hamburg, Germany, as well as virtually. With exciting new developments in diabetes treatment in the forefront of our minds, as described by the EASD President, Chantal Mathieu, presenter Paul Franks from Lund University, Sweden, took to the stage to deliver ‘ADA/EASD Precision Medicine in Diabetes Initiative: Executive Summary of the Second Consensus Report’. Franks provided the key updates to the consensus, published on 5th October 2023, only hours before the presentation.
{"title":"Precision Medicine in Diabetes","authors":"Natasha Meunier-McVey","doi":"10.33590/emjdiabet/10307138","DOIUrl":"https://doi.org/10.33590/emjdiabet/10307138","url":null,"abstract":"THE 59th Annual Meeting of the European Association for the Study of Diabetes (EASD) took place in Hamburg, Germany, as well as virtually. With exciting new developments in diabetes treatment in the forefront of our minds, as described by the EASD President, Chantal Mathieu, presenter Paul Franks from Lund University, Sweden, took to the stage to deliver ‘ADA/EASD Precision Medicine in Diabetes Initiative: Executive Summary of the Second Consensus Report’. Franks provided the key updates to the consensus, published on 5th October 2023, only hours before the presentation.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"20 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139269244","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10303633
Anaya Malik
THE Primary Care Diabetes Europe (PCDE) study group shared the results of its educational projects focused on health inequalities in diabetes, in a symposium titled ‘A Spotlight on Health Inequalities by Gender, Ethnicity, and Migration Status’. The session was presented at the European Association for the Study of Diabetes (EASD) 2023 Annual Meeting, chaired by Pinar Topsever, Acıbadem University School of Medicine, Istanbul, Türkiye, and PCDE Board Member.
{"title":"Equity Versus Equality: A Spotlight on Health Inequalities","authors":"Anaya Malik","doi":"10.33590/emjdiabet/10303633","DOIUrl":"https://doi.org/10.33590/emjdiabet/10303633","url":null,"abstract":"THE Primary Care Diabetes Europe (PCDE) study group shared the results of its educational projects focused on health inequalities in diabetes, in a symposium titled ‘A Spotlight on Health Inequalities by Gender, Ethnicity, and Migration Status’. The session was presented at the European Association for the Study of Diabetes (EASD) 2023 Annual Meeting, chaired by Pinar Topsever, Acıbadem University School of Medicine, Istanbul, Türkiye, and PCDE Board Member.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"146 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139269500","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10303508
H. Hanaire, Nicolas Naiditch, V. Melki, Pierre Morcel, Nelly Puech, Emeric Scharbarg, Raquel Tirado-Godas, Guila Lancman, M. Schaller, Cécile Delval, Lucy Chaillous
Introduction: Hybrid closed loop (HCL) systems have the potential to improve glycaemic control in people with Type 1 diabetes (T1D). In France, patient technical education and assistance for HCL users is provided by trained nurses from home healthcare providers (HHP). The objective of this study was to evaluate satisfaction of people with T1D with HHP services. Methods: In total, 35 participants with T1D and a prescription for an HCL system were studied during 3 months after HCL initiation in two French hospitals. A series of questionnaires were completed by participants. The number of planned (per protocol) and unplanned HHP interactions was monitored. Glycaemic control at inclusion and Day 90 was compared; formal statistical testing was carried out post-hoc. Results: Client Satisfaction Questionnaire (CSQ-8) with HHP service was high both at Day 30 (mean CSQ-8 score: 28.9; 95% confidence interval [CI]: 28.0; 29.9) and at Day 90 (29.0; 95% CI: 27.9; 30.0). Hypoglycemia Fear Survey-II (HFS-II) score (standard deviation) decreased from 31.2 (±15.7) at inclusion to 23.1 (±16.8) at Day 90. Participants had a median number of four home visits and two phone calls, but important differences were observed between participants: total interactions with HHP nurses ranged between five and 12 contacts, and 45.7% of participants requested unplanned interactions. Glycaemic control improved significantly: mean time in range increased from 57.0% (±13.3) at inclusion to 71.4% (±9.4) at Day 90 (p<0.001). Conclusion: HHP services for early phase HCL implementation were met with high client satisfaction levels. Study results emphasise the need for a personalised HHP approach.
{"title":"Satisfaction with Home Healthcare Provider Service in Adults with Type 1 Diabetes Using a Hybrid Closed Loop System: The SATURN Study","authors":"H. Hanaire, Nicolas Naiditch, V. Melki, Pierre Morcel, Nelly Puech, Emeric Scharbarg, Raquel Tirado-Godas, Guila Lancman, M. Schaller, Cécile Delval, Lucy Chaillous","doi":"10.33590/emjdiabet/10303508","DOIUrl":"https://doi.org/10.33590/emjdiabet/10303508","url":null,"abstract":"Introduction: Hybrid closed loop (HCL) systems have the potential to improve glycaemic control in people with Type 1 diabetes (T1D). In France, patient technical education and assistance for HCL users is provided by trained nurses from home healthcare providers (HHP). The objective of this study was to evaluate satisfaction of people with T1D with HHP services. Methods: In total, 35 participants with T1D and a prescription for an HCL system were studied during 3 months after HCL initiation in two French hospitals. A series of questionnaires were completed by participants. The number of planned (per protocol) and unplanned HHP interactions was monitored. Glycaemic control at inclusion and Day 90 was compared; formal statistical testing was carried out post-hoc. Results: Client Satisfaction Questionnaire (CSQ-8) with HHP service was high both at Day 30 (mean CSQ-8 score: 28.9; 95% confidence interval [CI]: 28.0; 29.9) and at Day 90 (29.0; 95% CI: 27.9; 30.0). Hypoglycemia Fear Survey-II (HFS-II) score (standard deviation) decreased from 31.2 (±15.7) at inclusion to 23.1 (±16.8) at Day 90. Participants had a median number of four home visits and two phone calls, but important differences were observed between participants: total interactions with HHP nurses ranged between five and 12 contacts, and 45.7% of participants requested unplanned interactions. Glycaemic control improved significantly: mean time in range increased from 57.0% (±13.3) at inclusion to 71.4% (±9.4) at Day 90 (p<0.001). Conclusion: HHP services for early phase HCL implementation were met with high client satisfaction levels. Study results emphasise the need for a personalised HHP approach.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"85 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139269736","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10305435
S. M. Mukherjee, Aimee Dawson, Katherine M Carey
The incidence of diabetes has been increasing and, in parallel, so has the incidence of females in their childbearing years with diabetes. Preconception care is important in females with diabetes due many factors related to fertility, blood glucose control, and complications. For example, many individuals with Type 2 diabetes are obese, which can affect contraceptive efficacy, fertility, and fetal growth. Additionally, patients with all types of diabetes are at risk for disordered eating, which can be harmful to a developing fetus. Both hypoglycaemia and hyperglycaemia are known to increase the risk of adverse maternal and neonatal outcomes, including during the first trimester, when many females are not aware of pregnancy. Additionally, individuals with diabetes are at risk for complications, such as atherosclerotic cardiovascular disease, nephropathy, retinopathy, and neuropathy, that can lead to complicated pregnancies. Importantly, several of the medications used to control blood glucose, and manage diabetes complications, are not recommended for use during pregnancy due to potential fetal harm. For these reasons, females with diabetes in their childbearing years are encouraged to utilise reliable contraception, so that pregnancies can be planned, or should be treated with medications with low teratogenicity potential. Thus, the preconception care of females with diabetes is complex, and the increasing prevalence of this patient population warrants greater awareness among clinicians. This narrative review summarises the current standard of preconception care for individuals with diabetes, including the management of contraception, weight, blood glucose, hypertension, and dyslipidaemia.
{"title":"Preconception Care for Individuals with Diabetes","authors":"S. M. Mukherjee, Aimee Dawson, Katherine M Carey","doi":"10.33590/emjdiabet/10305435","DOIUrl":"https://doi.org/10.33590/emjdiabet/10305435","url":null,"abstract":"The incidence of diabetes has been increasing and, in parallel, so has the incidence of females in their childbearing years with diabetes. Preconception care is important in females with diabetes due many factors related to fertility, blood glucose control, and complications. For example, many individuals with Type 2 diabetes are obese, which can affect contraceptive efficacy, fertility, and fetal growth. Additionally, patients with all types of diabetes are at risk for disordered eating, which can be harmful to a developing fetus. Both hypoglycaemia and hyperglycaemia are known to increase the risk of adverse maternal and neonatal outcomes, including during the first trimester, when many females are not aware of pregnancy. Additionally, individuals with diabetes are at risk for complications, such as atherosclerotic cardiovascular disease, nephropathy, retinopathy, and neuropathy, that can lead to complicated pregnancies. Importantly, several of the medications used to control blood glucose, and manage diabetes complications, are not recommended for use during pregnancy due to potential fetal harm. For these reasons, females with diabetes in their childbearing years are encouraged to utilise reliable contraception, so that pregnancies can be planned, or should be treated with medications with low teratogenicity potential. Thus, the preconception care of females with diabetes is complex, and the increasing prevalence of this patient population warrants greater awareness among clinicians. This narrative review summarises the current standard of preconception care for individuals with diabetes, including the management of contraception, weight, blood glucose, hypertension, and dyslipidaemia.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"9 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139267386","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10309803
Avarna Agarwal, Anita Arya, R. Saxena, Simmi Dube
Background: Diabetes is a global pandemic. Mean platelet volume (MPV) is an indicator of increased platelet activity, which is considered to play a role in the development of vascular complications in diabetes. Platelet volume is strongly and independently related with glycaemic control in Type 2 diabetes (T2D). Aim: To study the MPV in patients with T2D, and its correlation with HbA1c, duration of T2D, and microvascular complications. Methodology: This was a cross-sectional, observational study conducted at the Department of Medicine, Gandhi Medical College, Bhopal, India, during a period of 18 months on 300 patients with T2D. Blood glucose, HbA1c, MPV, fundoscopy, and 24-hour urine protein were done. Data were represented as mean+/-standard deviation and statistical analysis was done using SPSS software (IBM, Armonk, New York, USA). Results: The mean age of patients was 56.64±8.69 years, with 52% of the patients being females. Of these patients, 18.3% had HbA1c between 6.5–8.0%, 51.7% between 8.1–10.0% and the rest above 10.0%. A total of 51% of the patients had diabetes for 6–10 years of duration and 30% for more than 10 years. Patients with higher HbA1c level and prolonged duration of diabetes had higher MPV (p<0.001). Patients with advanced diabetic retinopathy changes and nephropathy also had higher MPV (p<0.05). Conclusion: Measurement of MPV in patients with T2D can be a useful and easily available prognostic marker, and hence assist clinicians to anticipate the occurrence of microvascular complications associated with the disease, especially in resource-poor settings, and reduce the burden of cost for the patient.
{"title":"Mean Platelet Volume in Type 2 Diabetes: Correlation with Poor Glycaemic Control","authors":"Avarna Agarwal, Anita Arya, R. Saxena, Simmi Dube","doi":"10.33590/emjdiabet/10309803","DOIUrl":"https://doi.org/10.33590/emjdiabet/10309803","url":null,"abstract":"Background: Diabetes is a global pandemic. Mean platelet volume (MPV) is an indicator of increased platelet activity, which is considered to play a role in the development of vascular complications in diabetes. Platelet volume is strongly and independently related with glycaemic control in Type 2 diabetes (T2D). Aim: To study the MPV in patients with T2D, and its correlation with HbA1c, duration of T2D, and microvascular complications. Methodology: This was a cross-sectional, observational study conducted at the Department of Medicine, Gandhi Medical College, Bhopal, India, during a period of 18 months on 300 patients with T2D. Blood glucose, HbA1c, MPV, fundoscopy, and 24-hour urine protein were done. Data were represented as mean+/-standard deviation and statistical analysis was done using SPSS software (IBM, Armonk, New York, USA). Results: The mean age of patients was 56.64±8.69 years, with 52% of the patients being females. Of these patients, 18.3% had HbA1c between 6.5–8.0%, 51.7% between 8.1–10.0% and the rest above 10.0%. A total of 51% of the patients had diabetes for 6–10 years of duration and 30% for more than 10 years. Patients with higher HbA1c level and prolonged duration of diabetes had higher MPV (p<0.001). Patients with advanced diabetic retinopathy changes and nephropathy also had higher MPV (p<0.05). Conclusion: Measurement of MPV in patients with T2D can be a useful and easily available prognostic marker, and hence assist clinicians to anticipate the occurrence of microvascular complications associated with the disease, especially in resource-poor settings, and reduce the burden of cost for the patient.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"111 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139267888","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10301251
The following highlights spotlight abstracts presented at the 59th European Association for the Study of Diabetes (EASD) Annual Meeting. Selected abstracts cover pertinent and timely topics, including cardiopulmonary performance in patients with Type 2 diabetes and obesity, and gestational diabetes screening in early pregnancy.
{"title":"EASD 2023 Abstract Highlights","authors":"","doi":"10.33590/emjdiabet/10301251","DOIUrl":"https://doi.org/10.33590/emjdiabet/10301251","url":null,"abstract":"The following highlights spotlight abstracts presented at the 59th European Association for the Study of Diabetes (EASD) Annual Meeting. Selected abstracts cover pertinent and timely topics, including cardiopulmonary performance in patients with Type 2 diabetes and obesity, and gestational diabetes screening in early pregnancy.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139267518","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10308765
On 2nd October, Chantal Mathieu, European Association for the Study of Diabetes (EASD) President, welcomed the more than 11,000 participants to the EASD’s 59th Annual Meeting. This year, Hamburg, Germany, played host to what Mathieu introduced as "scientific fireworks," while the city celebrated German Unity Day.
{"title":"Review of the 59th European Association for the Study of Diabetes (EASD) Annual Meeting","authors":"","doi":"10.33590/emjdiabet/10308765","DOIUrl":"https://doi.org/10.33590/emjdiabet/10308765","url":null,"abstract":"On 2nd October, Chantal Mathieu, European Association for the Study of Diabetes (EASD) President, welcomed the more than 11,000 participants to the EASD’s 59th Annual Meeting. This year, Hamburg, Germany, played host to what Mathieu introduced as \"scientific fireworks,\" while the city celebrated German Unity Day.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139267103","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}
Pub Date : 2023-11-16DOI: 10.33590/emjdiabet/10307262
James Woijoo Kim, Giada Sebastiani
Since the release of the EMPA-REG trial in 2015, the focus in diabetes management has been shifted from a glucocentric approach to a more organ-protective approach. Much of the focus has been on cardiorenal protections, thanks to the numerous landmark trials being published in recent years. However, the significance of what seems to be an innocuous fatty deposition in the liver has received less attention than it deserves for many years, especially in people living with diabetes and obesity, but its impact on health has slowly been highlighted more in the last decade. Bodies of research are now suggesting that non-alcoholic fatty liver disease (NAFLD) is a significant independent risk factor for cardiovascular disease, including myocardial infarction, heart failure, and atrial fibrillation, while it carries the increased risk of cirrhosis, hepatocellular carcinoma, and extrahepatic cancers. Numerous organisations have begun to publish guidelines focusing on screening and treating NAFLD in recent years in an effort to combat this underappreciated, underdiagnosed, and undertreated complication of diabetes and obesity. This review paper will provide an overview of NAFLD, highlighting the argument that NAFLD is indeed an independent cardiovascular risk factor, discussing the proposed pathophysiology of NAFLD being a cardiovascular risk factor, and suggesting a highly validated hepatic fibrosis screening tool, which is a simple, easy-to-use tool to screen for hepatic fibrosis, and can be used in primary care offices.
{"title":"Hidden Complication of Obesity and Diabetes: Is It Time to Put More Focus on Fatty Liver?","authors":"James Woijoo Kim, Giada Sebastiani","doi":"10.33590/emjdiabet/10307262","DOIUrl":"https://doi.org/10.33590/emjdiabet/10307262","url":null,"abstract":"Since the release of the EMPA-REG trial in 2015, the focus in diabetes management has been shifted from a glucocentric approach to a more organ-protective approach. Much of the focus has been on cardiorenal protections, thanks to the numerous landmark trials being published in recent years. However, the significance of what seems to be an innocuous fatty deposition in the liver has received less attention than it deserves for many years, especially in people living with diabetes and obesity, but its impact on health has slowly been highlighted more in the last decade. Bodies of research are now suggesting that non-alcoholic fatty liver disease (NAFLD) is a significant independent risk factor for cardiovascular disease, including myocardial infarction, heart failure, and atrial fibrillation, while it carries the increased risk of cirrhosis, hepatocellular carcinoma, and extrahepatic cancers. Numerous organisations have begun to publish guidelines focusing on screening and treating NAFLD in recent years in an effort to combat this underappreciated, underdiagnosed, and undertreated complication of diabetes and obesity. This review paper will provide an overview of NAFLD, highlighting the argument that NAFLD is indeed an independent cardiovascular risk factor, discussing the proposed pathophysiology of NAFLD being a cardiovascular risk factor, and suggesting a highly validated hepatic fibrosis screening tool, which is a simple, easy-to-use tool to screen for hepatic fibrosis, and can be used in primary care offices.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139267590","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}
Primary hypothyroidism is a frequent presentation in primary care, and is treated with levothyroxine sodium tablets once daily in the morning in the fasting state. With an adequate dose, the goal is to achieve a thyroid stimulating hormone in the normal range in 6–8 weeks. Medications, foods, and gastrointestinal conditions can interfere with the absorption of the levothyroxine tablet. This can lead to increased visits to the laboratory and physician, necessitating frequent dosage changes, and causing suboptimal care. The newly-introduced oral solutions and soft gel capsule formulations received approval for use by regulatory authorities. This article describes the kinetics of levothyroxine, examines the available evidence from the literature, and summarises the rightful place of the levothyroxine solution from the perspective of the clinical practitioner. At the end of the analysis, it is evident that more robust trials with this new formulation are needed to consider a switchover from tablet form for millions of patients, in order to justify the cost. The newer levothyroxine formulations may have a role in selected patients with resistant hypothyroidism.
{"title":"Newer Oral Levothyroxine Formulations: Is It Time to Switch Over?","authors":"V. Rajkumar","doi":"10.33590/emj/10306765","DOIUrl":"https://doi.org/10.33590/emj/10306765","url":null,"abstract":"Primary hypothyroidism is a frequent presentation in primary care, and is treated with levothyroxine sodium tablets once daily in the morning in the fasting state. With an adequate dose, the goal is to achieve a thyroid stimulating hormone in the normal range in 6–8 weeks. Medications, foods, and gastrointestinal conditions can interfere with the absorption of the levothyroxine tablet. This can lead to increased visits to the laboratory and physician, necessitating frequent dosage changes, and causing suboptimal care. The newly-introduced oral solutions and soft gel capsule formulations received approval for use by regulatory authorities. This article describes the kinetics of levothyroxine, examines the available evidence from the literature, and summarises the rightful place of the levothyroxine solution from the perspective of the clinical practitioner. At the end of the analysis, it is evident that more robust trials with this new formulation are needed to consider a switchover from tablet form for millions of patients, in order to justify the cost. The newer levothyroxine formulations may have a role in selected patients with resistant hypothyroidism.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128038218","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}
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