Sunday, November 27, 2022

What’s New In Diabetes Treatment

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Dexcom G6 Drops A1c From 101% To 71% In People With Type 2 Diabetes

What’s New in Diabetes Mellitus Treatment

Dr. Thomas Grace read out results from a six-month study that assessed the effect of Dexcom G6 use among people with type 2 diabetes on basal insulin-only, other glucose-lowering medications, or diet and exercise. The study included 38 participants with an average A1C of 10.1% , Time in Range of 57%, BMI of 36 kg/m2, average age of 55 years, who had lived with diabetes for 14 years on average, and typically completed fewer than three fingerstick tests per day. Participants received CGM training from the clinic staff and attended three- and six-month clinic visits to review data and adjust medications as needed.

After six months, the data showed:

  • Time in Range : increased by 3.6 hours per day to 72%.

  • Time in hyperglycemia : fell 3.6 hours per day, from 43% to 28%. People also spent two fewer hours per day in severe hyperglycemia .

  • A1C reduction: A1C went down to 7.1% . This was seen among people using one, two, or more medications.

Replacing Missing Cells With Cell Therapy

Although still in the very early stages of development, cell therapy is one of the biggest hopes towards developing a cure for diabetes, especially for type 1 diabetes. Replacing the missing insulin-producing cells could potentially recover normal insulin production and cure patients.

However, early attempts to transplant pancreatic cells have largely failed, mostly due to immune reactions that reject and destroy the implanted cells. The lack of donors is also a limitation.

One of the most advanced alternatives comes from the Diabetes Research Institute in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. This mini-pancreas is then implanted into the omentum, a part of the abdominal lining. A phase I/II trial is ongoing, but the DRI announced its first successful results in 2016, revealing that the first patient in Europe treated with this approach no longer requires insulin therapy.

This can be the beginning of a new era in islet transplantation. Our ultimate goal is to prevent the need for lifelong anti-rejection therapy, stated Camillo Ricordi, Director of the DRI.

A similar device is being developed by the US company ViaCyte, in collaboration with the nonprofit organization JDRF. A phase I/II trial is ongoing and has already proved the device is safe. The company is now working on improving the engraftment of insulin-producing cells.

Determining The Genetic Risk For Gestational Diabetes

Research has identified more than 100 genetic variants linked to risk for developing type 2 diabetes in humans. However, the extent to which these same genetic variants might affect a womans probability for getting gestational diabetes has not been investigated.

Pathway to Stop Diabetes® Accelerator awardee Marie-France Hivert, MD, of Harvard University set out to answer this critical question. Dr. Hivert found that indeed genetic determinants of type 2 diabetes outside of pregnancy are also strong risk factors for gestational diabetes. This study was published in the journal Diabetes.

The implications? Because of this finding, doctors in the clinic may soon be able to identify women at risk for getting gestational diabetes and take proactive steps to prevent it. Powe, C. E., Nodzenski, M., Talbot, O., Allard, C., Briggs, C., Leya, M. V., Hivert, M.-F. . Genetic Determinants of Glycemic Traits and the Risk of Gestational Diabetes Mellitus. Diabetes, 67, 27032709.

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What’s New In Diabetes

Diabetes affects 25.8 million, or 8.3% of the population, in the US

  • Of those, 18.8 million are diagnosed 7 million are undiagnosed
  • Among US residents 65 years, 10.9 million, or 26.9% , had diabetes in 2010
  • About 215,000 people < 20 years had diabetes in the US in 2010
  • Each year, more than 13,000 young people are diagnosed with type 1 diabetes

Stimulating Younger Generations To Have A Proper Nutrition Plan

Whats New in Diabetes

One of the most important studies related to diabetes is that the main factor that is causing it lies in the nutrition of people, especially younger generations. The main cause of type 2 diabetes is fast food, processed meat, and sugar in beverages. The lack of psychical activity can have negative effects as well. In that matter, the best way to prevent diabetes is to teach children to have a healthier diet and to exercise more.

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What Else Should I Know About Taking Medicines For Diabetes

Even if you take medicines for diabetes, you still need to eat a healthy diet and do regular physical activity. These will help you manage your diabetes.

It is important to make sure that you understand your diabetes treatment plan. Talk to your provider about:

  • What your target blood sugar level is
  • What to do if your blood sugar gets too low or too high
  • Whether your diabetes medicines will affect other medicines you take
  • Any side effects you have from the diabetes medicines

You should not change or stop your diabetes medicines on your own. Talk to your provider first.

Some people who take diabetes medicines may need medicines for high blood pressure, high cholesterol, or other conditions. This may help you avoid or control any complications of diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Identification Of A New Player In Type 1 Diabetes Risk

Type 1 diabetes is caused by an autoimmune attack of insulin-producing beta-cells. While genetics and the environment are known to play important roles, the underlying factors explaining why the immune system mistakenly recognize beta-cells as foreign is not known. Now, Dr. Delong has discovered a potential explanation. He found that proteins called Hybrid Insulin Peptides are found on beta-cells of people with type 1 diabetes and are recognized as foreign by their immune cells. Even after diabetes onset, immune cells are still present in the blood that attack these HIPs.

Next, Dr. Delong wants to determine if HIPs can serve as a biomarker or possibly even targeted to prevent or treat type 1 diabetes.Baker, R. L., Rihanek, M., Hohenstein, A. C., Nakayama, M., Michels, A., Gottlieb, P. A., Haskins, K., & Delong, T. . Hybrid Insulin Peptides Are Autoantigens in Type 1 Diabetes. Diabetes, 68, 18301840.

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Type 2 Diabetes: Experimental Therapy Could Remove Need For Insulin

Scientists have proposed a new therapy for type 2 diabetes. If proven effective, the therapy could help some people discontinue insulin treatment.

Scientists have proposed a new therapy for the treatment of type 2 diabetes, with a proof-of-concept study showing positive initial results. If effective, the therapy may mean that some people can stop taking insulin treatment.

The authors of the research presented their findings at UEG Week Virtual 2020, a conference organized by United European Gastroenterology, a professional nonprofit organization for specialists in digestive health.

National Institute of Diabetes and Digestive and Kidney Diseases , a person may have type 2 diabetes when their blood sugar is too high.

People gain blood sugar, or blood glucose, mainly from the food they eat. Insulin helps cells access this glucose to use as energy. However, for a person with type 2 diabetes, either their body does not make enough insulin or their cells do not respond to insulin correctly.

This then means that the glucose in their blood increases, which can lead to complications of diabetes, such as heart and kidney disease, visual impairment, and loss of sensation in the limbs. The higher the blood glucose over time, the

Centers for Disease Control and Prevention , about 1 in 10 adults in the United States have diabetes, and 9095% of these individuals have type 2 diabetes.

Aiming For Balance: Type 1 Diabetes And Exercise Management

New research is changing treatment options for Type 2 diabetes | 7NEWS

Experts on exercise, nutrition, and type 1 diabetes discussed the latest strategies and recommendations for blood glucose management during physical activity. Endocrinologist Dr. Ian Gallen from the UKs National Health Service shared the effects of different types of exercise on blood glucose:

  • Aerobic exercise causes blood glucose to fall, while intense anaerobic exercise can cause a rise in glucose levels.

  • Weight and resistance training can cause an initial rise in glucose, but repetition over time can cause a decrease.

  • Altering the timing and order of exercises can help stabilize blood glucose levels over long periods of physical activity.

  • Careful carbohydrate consumption before, during, and after exercise, along with the use of short-acting mealtime insulin, is crucial to avoid low blood sugar after exercise.

Its important to remember that different peoples glucose levels can respond differently to exercise. Always make sure that you have everything you need in case of an emergency and talk to your healthcare team to come up with an exercise plan.

How much should you be exercising? According to the American Diabetes Association, adults with type 1 should engage in at least 150 minutes of moderate to vigorous exercise per week, with no more than two consecutive days without activity. However, only about 30% of people with type 1 diabetes meet this goal. Here are some strategies for people with diabetes to improve glucose management while exercising:

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Evidence Summary On Type 2 Diabetes

The prevalence of diabetes is increasing, with an estimated 6% of Australians currently diagnosed with the chronic disease.5

Diabetes impacts quality of life, life expectancy and morbidity as a result of microvascular complications and the increased risk of macrovascular complications .6

Good glycaemic control reduces the development or progression of diabetes complications and can improve quality of life.26

About 60% of people with type 2 diabetes have cardiovascular disease and around 65% of all cardiovascular disease deaths in Australia occur in people with diabetes.7

Addressing lifestyle factors, blood pressure and blood lipids are just as essential, as they seem even more effective than glycaemic control in reducing the risk of cardiovascular complications.8

Reducing risk of cardiovascular events in people with type 2 diabetes requires concurrent management of lifestyle factors, blood pressure, lipids and blood glucose.5

Amazing Breakthroughs In Diabetes Research That Are Giving Us Hope

According to recent research, we’re not entirely sure how many diseases the label ‘diabetes‘ covers. But no matter what causes our bodies to struggle with their blood sugar levels, it’s a serious condition that requires daily care.

Scientists have been working hard to find cures, new treatments, and better management techniques for the millions of people worldwide dealing with diabetes.

Here are some of the latest developments you need to know about.

1. Insulin producing implants made from stem cells

Clinical trials began last year for testing for ViaCyte’s PEC-Direct device a credit-card sized implant containing insulin-producing cells derived from stem cells.

Previous research had shown the implants could mature and function inside patients. Together with a cohort of volunteers who started testing in January, the new research should tell us soon whether the technology can help people with type-1 diabetes.

2. Brand new beta cells

Type 1 diabetes develops when a person’s immune system wipes out insulin-producing beta cells in the pancreas.

But it turns out that another type of immature beta cell has been hiding in our pancreases all along, and scientists think it might be possible to use these ‘virgin beta cells’ to restore the functionality of the pancreas.

3. A common blood pressure medication

4. A unique transplant

One woman with severe type 1 diabetes has spent a year without insulin injections thanks to an experimental transplant.

5. An extreme diet

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Management Of Intercurrent Medical Illness

Patients with intercurrent illness become more insulin resistant because of the effects of increased counterregulatory hormones. Therefore, despite decreased nutritional intake, glycemia may worsen.

Patients on oral agents may need transient therapy with insulin to achieve adequate glycemic control. In patients who require insulin, scheduled doses of insulin, as opposed to sliding scale insulin, are far more effective in achieving glycemic control.

Metformin is a special case. If patients taking metformin have any illness that leads to dehydration or hypoperfusion, the drug should be temporarily discontinued because of a possible increased risk of lactic acidosis.

What Are The Types Of Medicines For Type 2 Diabetes

Whats New in Diabetes

There are several different medicines for type 2 diabetes. Each works in a different way. Many diabetes medicines are pills. There are also medicines that you inject under your skin, such as insulin.

Over time, you may need more than one diabetes medicine to manage your blood sugar. You might add another diabetes medicine or switch to a combination medicine. A combination medicine is a pill than contains more than one type of diabetes medicine. Some people with type 2 diabetes take both pills and insulin.

Even if you don’t usually take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

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What Does This Mean For The Nhs

Vast expense the total cost associated with diabetes in the UK stands at £23.7 billion and is predicted to rise to £39.8 billion by 2035/6. Its not just treatment costs but also wider economic implications, such as time off work. Treating the complications of diabetes, such as cardiovascular problems or damage to the nerves, kidneys, eyes or feet, is the biggest expense.

The solution? Prevention, reversal, and better management of symptoms, so people dont get to the stage where they have complications. It needs a huge public health drive to raise awareness, change habits and prevent type 2 developing in the first place.

How Close Are We To A Cure For Type 2 Diabetes

Type 2 diabetes is one of the worlds greatest health problems. It affects about 400 million people globally. If its uncontrolled, it can lead to dangerous complications like kidney failure, blindness, heart attack, and stroke. But while there are over 30 different drugs on the market to help manage this disease and prevent these problems, none provide an actual cure.

One reason is that until recently, we didnt quite understand the full scope of the problem. Two decades ago, if you asked a diabetes specialist to explain the cause of type 2 diabetes, they would say insulin resistance. Insulin is a hormone made by the pancreas that helps the glucose in your blood enter cells in your muscle, fat, and liver, where its used for energy. But when you have insulin resistance, these muscle, fat, and liver cells dont respond well to it. As a result, your pancreas has to make more and more insulin to compensate. Over time, this can lead to type 2 diabetes.

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New Abridged Recommendations For Primary Care Providers

The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers, highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects:

  • Prediabetes

  • Diagnosis and treatment of vascular complications

  • Intensification of insulin therapy in type 2 diabetes

The recommendations can be accessed at American Diabetes Association DiabetesPro Professional Resources Online, Clinical Practice Recommendations 2015.

Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. Management includes the following:

  • Appropriate goal setting

  • Appropriate self-monitoring of blood glucose

  • Regular monitoring for complications

  • Laboratory assessment

Ideally, blood glucose should be maintained at near-normal levels . However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals .

Aggressive glucose lowering may not be the best strategy in all patients. Individual risk stratification is highly recommended. In patients with advanced type 2 diabetes who are at high risk for cardiovascular disease, lowering HbA1c to 6% or lower may increase the risk of cardiovascular events.

What Are The Types Of Medicines For Type 1 Diabetes

What are the latest new treatments in diabetes

If you have type 1 diabetes, you must take insulin because your body no longer makes it. Different types of insulin start to work at different speeds, and the effects of each last a different length of time. You may need to use more than one type.

You can take insulin several different ways. The most common are with a needle and syringe, an insulin pen, or an insulin pump. If you use a needle and syringe or a pen, you have to take insulin several times during the day, including with meals. An insulin pump gives you small, steady doses throughout the day. Less common ways to take insulin include Inhalers, injection ports, and jet injectors.

In rare cases, taking insulin alone might not be enough to manage your blood sugar. Then you would need to take another diabetes medicine.

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Possible Adverse Reactions When Taking Sglt2i

Potential side effects of SGLT-2i include genital yeast infections, urinary tract infections, constipation and flu-like symptoms. When combined with insulin or medications that increase insulin production, SGLT-2i can cause hypoglycemia. And while they have been shown in some cases to prevent progression to end stage kidney disease, they are not suitable for anyone with advanced CKD.5

These are exciting new medications, and if you are an adult with poorly controlled type 2 diabetes despite diet and exercise modifications and the use of metformin, and you have established cardiovascular disease or chronic kidney disease , one of the SGLT2 inhibitors may be right for you, says John Kennedy, MD, chief medical officer of the American Medical Group Association. Yet, they are not for everyone, and you cant assume that you should be on one of these drugs just because you have T2D and CVD or CKD.

Dr. Kennedy advises patients to review your current medical history and mediation list with your doctor to determine the safest and most effective treatment to meet your circumstances best. He also recommends that you check with your health insurer and pharmacist to understand what, if any, out-of-pocket costs might be expected of you, before you start taking any new diabetes medication.

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