Glycosmedia Weekly Diabetes News - 10/29/2021

Association of Sodium-Glucose Cotransporter–2 Inhibitors With Fracture Risk in Older Adults With Type 2 Diabetes

In this nationwide Medicare cohort, initiating an SGLT-2i was not associated with an increased risk of fracture in older adults with T2D compared with initiating a DPP-4i or GLP-1RA, with consistent results across categories of frailty, age, and insulin use (JAMA)

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

There is a potential to identify both T2D and T1D at stages well before the onset of currently recognized clinical disease (Diabetes)

Renal Complications and Duration of Diabetes: An International Comparison in Persons with Type 1 Diabetes

This analysis used three nationwide registries of persons with T1D. Despite recent use of more effective diabetes therapies, a substantial proportion of persons with T1D have renal complications at < 20 years after diagnosis. Efficient glucose-lowering and renal-protective strategies are needed in persons with T1D (Diabetes Therapy)

A systematic review and meta-analysis of interventions to preserve insulin-secreting beta cell function in people newly diagnosed with type 1 diabetes: results from intervention studies aimed at improving glucose control

This is the largest comprehensive review of RCTs in this area. It demonstrates a lack of robust evidence that interventions to improve glucose control preserve beta cell function in new onset type 1 diabetes, although analysis was hampered by low quality evidence and inconsistent reporting of studies (Diabetic Medicine)

Real-world screening for diabetes in early pregnancy: Improved screening uptake using universal glycated haemoglobin

Universal early pregnancy HbA1c appears feasible as an early screening test for women at risk of hyperglycaemia in pregnancy and would expedite and increase screening in Aboriginal women compared to an early OGTT (Primary Care Diabetes)

Factors Associated with Adherence to Clinical Practice Guidelines for Patients with Type 2 Diabetes Mellitus: Results of a Spanish Delphi Consensus

Nonadherence to CPGs on T2DM is a multifactorial problem but the existence multiple CPGs, the lack of time, the therapeutic inertia, and insufficient human resources have been identified as factors limiting adherence. Hypoglycemia continues to be a barrier for achievement of targets recommended by CPGs (Journal of Diabetes Research)

Differences in outcomes of hospitalizations for heart failure after SGLT2 inhibitor treatment: effect modification by atherosclerotic cardiovascular disease

In this study, history of established ASCVD was associated with different hHF risks among SGLT2 inhibitors. For T2D patients without ASCVD, dapagliflozin may offer a more favorable hHF reduction effect, compared to empagliflozin, in clinical practice. Future prospective studies should be conducted to validate our findings (Cardiovascular Diabetology)

Prediction model for the onset risk of impaired fasting glucose: a 10-year longitudinal retrospective cohort health check-up study

The prediction model for the onset risk of IFG had good predictive ability in the health check-up cohort (BMC Endocrine Disorders)

The importance of addressing multiple risk markers in type 2 diabetes: results from the LEADER and SUSTAIN 6 trials

In persons with type 2 diabetes, improvements in ≥2 risk markers conferred cardiovascular risk reduction versus none or 1 improved risk marker. The nephropathy risk decreased with improvement in more risk markers. These findings stress the importance of multifactorial interventions targeting all risk markers (Diabetes, Obesity and Metabolism)