Research compares efficacy of different classes of diabetes drugs | Study links autonomy support to reduced distress in diabetes | Prediabetes tied to CV, renal disease risks, study finds
April 19, 2018
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Diabetes in Focus
Research compares efficacy of different classes of diabetes drugs
UK researchers analyzed 236 trials involving 176,310 patients with type 2 diabetes and found that SGLT-2 inhibitors and GLP-1 agonist drugs were associated with a 20% and 18% reduced mortality risk compared with placebo, respectively, while DPP-4 inhibitors were not. The findings in the Journal of the American Medical Association revealed that GLP-1 agonists and DPP-4 inhibitors increase natural insulin levels, while GLT-2 inhibitors increase the amount of sugar excreted by the body.
United Press International (4/18) 
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Study links autonomy support to reduced distress in diabetes
Researchers used a cohort of 308 veterans with type 2 diabetes and found an association between diabetes distress and higher subsequent A1C levels, while autonomy support from family and friends was tied to lower A1C levels. Researchers said the findings, published in Diabetes Care, show that autonomy support may help reduce distress to lead to improved glycemic control.
Physician's Briefing/HealthDay News (4/18) 
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Prediabetes tied to CV, renal disease risks, study finds
A study in The Lancet Diabetes & Endocrinology showed that 7.7% of individuals with prediabetes had albuminuria, 51.2% had dyslipidemia, 4.6% showed reduced estimated glomerular filtration rate and 36.6% had hypertension, and the 10-year cardiovascular event risk was between 5% and 7%. Researchers evaluated data from four US National Health and Nutrition Examination Surveys involving 27,971 adults, ages 20 and older, and found greater improvements in all treatments for CV and renal risks, except for smoking, among individuals with diagnosed diabetes, compared with those with prediabetes.
Endocrinology Advisor (4/18) 
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Nutrition & Wellness
Researchers find muscle metabolic deficiencies in young adults with diabetes
A study in Diabetologia showed a significantly lower mitochondrial oxidative capacity, especially at Complex II of the electron transport chain, increased mitochondrial H2O2 emission at Complex III and decreased Ca2+ retention capacity in the muscles of physically active young adults with type 1 diabetes, compared with controls. Canadian researchers used a cohort of 24 young adults with and without diabetes and also found that those with diabetes had an increased number and size of autophagic remnants in muscles.
Physician's Briefing/HealthDay News (4/18) 
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Study: Food insecurity is risk factor for advanced hepatic fibrosis
The risk for advanced hepatic fibrosis is almost three times higher for patients with diabetes and nonalcoholic fatty liver disease if they are food-insecure, according to a study presented at the International Liver Congress 2018. Dr. Russell Rosenblatt of New York Presbyterian Hospital said food insecurity may be better than other socioeconomic variables at predicting advanced fibrosis.
Medscape (free registration) (4/17) 
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Ambulatory BP predicts mortality more accurately than clinical BP, study finds
A study in The New England Journal of Medicine found 24-hour ambulatory blood pressure measurements had a stronger association with all-cause mortality and cardiovascular mortality than clinical measurements. The findings, based on data for 63,910 adults from the Spanish Ambulatory Blood Pressure Registry over the period from 2004 to 2014, showed mortality was higher with masked hypertension, which refers to normal clinical readings but elevated ambulatory readings, than white-coat hypertension or sustained hypertension.
Healio (free registration)/Cardiology Today (4/18),  Family Practice News (4/18) 
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Practice Update
Primary care docs cite third-party interference as top challenge
Medical Economics' 89th Annual Physician Report found 70% of primary care physicians said "third-party interference" was their biggest challenge. Solutions cited by physicians included dropping a payer, making workflow changes or switching to a direct primary care practice model.
Modern Medicine/Medical Economics (4/18) 
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Trends & Technology
National health spending up nearly 5% to $3.6T, report finds
An Altarum report found that national health spending grew by nearly 5% year-over-year to $3.6 trillion in February, fueled in part by growth in hospital spending, which rose from 2.7% in November to 4.3% in February. All major categories saw year-over-year spending growth, with nursing home care growing the fastest at 7.9%, and prescription drugs growing the slowest at 4.2%.
Healthcare Finance (4/17) 
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ADA News
Women's Interprofessional Network of the American Diabetes Association (WIN ADA)
The Association recently launched WIN ADA, a new member-only network for female physicians, scientists, educators, and other professionals in the field of diabetes. WIN ADA aims to strengthen the presence and recognize the contributions of women in diabetes research and clinical practice. The group will provide networking and career development opportunities to help women overcome gender-based barriers associated with professional advancement. Learn more and join today.
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