Curr Diab Rep

Purpose of ReviewTo identify a common effect of health information technologies (HIT) on the management of cardiovascular disease (CVD) risk factors among people with type 2 diabetes (T2D) across randomized control trials (RCT).Recent FindingsCVD is the most frequent cause of morbidity and mortality among patients with diabetes. HIT are effective in reducing HbA1c; however, their effect on cardiovascular risk factor management for patients with T2D has not been evaluated.SummaryWe identified 21 eligible studies (23 estimates) with measurement of SBP, 20 (22 estimates) of DBP, 14 (17 estimates) of HDL, 14 (17 estimates) of LDL, 15 (18 estimates) of triglycerides, and 10 (12 estimates) of weight across databases. We found significant reductions in SBP, DBP, LDL, and TG, and a significant improvement in HDL associated with HIT. As adjuvants to standard diabetic treatment, HIT can be effective tools for improving CVD risk factors among patients with T2D, especially in those whose CVD risk factors are not at goal.Electronic supplementary materialThe online version of this article (10.1007/s11892-019-1152-3) contains supplementary material, which is available to authorized users.1P30DK092950/National Institute of Diabetes and Digestive and Kidney Diseases/2019-04-27T00:00:00Z31030289PMC6486904628

Curr Diab Rep

This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income, female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of a team. Interventions varied considerably in session time, duration, and number. Most met standards for tailored, high-intensity interventions and half were theory-based. Overall, methodological quality was good but there were inconsistencies in the reporting of key information. Future research should report in greater detail CHW background, training, and supervision; examine factors associated with intervention effectiveness; and provide data on cost and cost-effectiveness.K01 DK102447/DK/NIDDK NIH HHS/United StatesP60 MD006912/MD/NIMHD NIH HHS/United States1 P60 MD006912/MD/NIMHD NIH HHS/United StatesU48 DP001933/DP/NCCDPHP CDC HHS/United States2018-10-16T00:00:00Z25374313PMC6191032vault:3098

Profil lipidique, cinétique d’apparition des diènes conjugués et activité paraoxonase-1 chez le diabétique de type 2 à Libreville au Gabon

L’objectif de ce travail était d’identifier la fréquence des dyslipidémies du diabétique de type 2 afin d’apprécier l’efficacité de leur prise en charge. Pour cela, une étude prospective et ponctuelle, a été menée du 1er janvier au 30 octobre 2010. Elle a concerné les patients diabétiques de type 2, avec ou sans complications macro et microvasculaires. Un bilan lipidique a été réalisé chez ces patients à jeun depuis 12 heures, associé à la détermination du temps de latence d’apparition des diènes conjugués et l’activité paraoxonase-1 (PON1). Il a été démontré que le LDL était élevé chez 65,2%, alors que le HDL était réduit chez 63,6% des diabétiques. Le profil le plus athérogène, caractérisé par une augmentation du LDL et une diminution du HDL intéressait 31,8% des sujets. La dyslipidémie classiquement associée au diabète de type 2, n’était retrouvée que chez 8,3% des patients. Ces anomalies quantitatives étaient accompagnées de modifications qualitatives des lipides, à type de diminution du temps de latence d’apparition des diènes conjugués ou de l’activité PON1 avec la chronicité de la maladie. Ces résultats suggèrent l’amélioration des mesures de prise en charge des dyslipidémies chez les diabétiques de type 2, non seulement avec les statines, mais également les dérivés de l’acide nicotinique et même des antioxydants comme la vitamine E.Mots clés: diabète de type 2, dyslipidémies, athérosclérose, oxydation LDL, paraoxonase

The Arabs Between East and West

News release announcing a speech by Dr. Fawzi Abu-Diab on The Arabs Between East and West

Urinary peptidomics provides a noninvasive humanized readout of diabetic nephropathy in mice

Nephropathy is among the most frequent complications of diabetes and the leading cause of end-stage renal disease. Despite the success of novel drugs in animal models, the majority of the subsequent clinical trials employing those drugs targeting diabetic nephropathy failed. This lack of translational value may in part be due to an inadequate comparability of human disease and animal models that often capture only a few aspects of disease. Here we overcome this limitation by developing a multimolecular noninvasive humanized readout of diabetic nephropathy based on urinary peptidomics. The disease-modified urinary peptides of 2 type 2 diabetic nephropathy mouse models were identified and compared with previously validated urinary peptide markers of diabetic nephropathy in humans to generate a classifier composed of 21 ortholog peptides. This classifier predicted the response to disease and treatment with inhibitors of the renin-angiotensin system in mice. The humanized classifier was significantly correlated with glomerular lesions. Using a human type 2 diabetic validation cohort of 207 patients, the classifier also distinguished between patients with and without diabetic nephropathy, and their response to renin-angiotensin system inhibition. Thus, a combination of multiple molecular features common to both human and murine disease could provide a significant change in translational drug discovery research in type 2 diabetic nephropathy

Oral diabetes medication monotherapy and short-term mortality in individuals with type 2 diabetes and coronary artery disease

Objective To determine whether sulfonylurea use, compared with non-sulfonylurea oral diabetes medication use, was associated with 2-year mortality in individuals with well-controlled diabetes and coronary artery disease (CAD). Research design and methods We studied 5352 US veterans with type 2 diabetes, obstructive CAD on coronary angiography, hemoglobin A1c ≤7.5% at the time of catheterization, and taking zero or one oral diabetes medication (categorized as no medications, non-sulfonylurea medication, or sulfonylurea). We estimated the association between medication category and 2-year mortality using inverse probability of treatment-weighted (IPW) standardized mortality differences and IPW multivariable Cox proportional hazards regression. Results 49%, 35%, and 16% of the participants were on no diabetes medications, non-sulfonylurea medications, and sulfonylureas, respectively. In individuals on no medications, non-sulfonylurea medications, and sulfonylureas, the unadjusted mortality rates were 6.6%, 5.2%, and 11.9%, respectively, and the IPW-standardized mortality rates were 5.9%, 6.5%, and 9.7%, respectively. The standardized absolute 2-year mortality difference between non-sulfonylurea and sulfonylurea groups was 3.2% (95% CI 0.7 to 5.7) (p=0.01). In Cox proportional hazards models, the point estimate suggested that sulfonylurea use might be associated with greater hazard of mortality than non-sulfonylurea medication use, but this finding was not statistically significant (HR 1.38 (95% CI 1.00 to 1.93), p=0.05). We did not observe significant mortality differences between individuals on no diabetes medications and non-sulfonylurea users. Conclusions Sulfonylurea use was common (nearly one-third of those taking medications) and was associated with increased 2-year mortality in individuals with obstructive CAD. The significance of the association between sulfonylurea use and mortality was attenuated in fully adjusted survival models. Caution with sulfonylurea use may be warranted for patients with well-controlled diabetes and CAD, and metformin or newer diabetes medications with cardiovascular safety data could be considered as alternatives when individualizing therapy

Developing priorities to achieve health equity through diabetes translation research: A concept mapping study

Introduction: The goal of diabetes translation research is to advance research into practice and ensure equitable benefit from scientific evidence. This study uses concept mapping to inform and refine future directions of diabetes translation research with the goal of achieving health equity in diabetes prevention and control. Research design and methods: This study used concept mapping and input from a national network of diabetes researchers and public health practitioners. Concept mapping is a mixed-method, participant-based process. First, participants generated statements by responding to a focus prompt ( Results: Ten clusters were identified containing between 6 and 12 statements from 95 total generated statements. The ranges of average importance and feasibility ratings for clusters were fairly high and narrow (3.62-4.09; 3.10-3.93, respectively). Clusters with the most statements in the go-zone quadrant (above average importance/feasibility) were Conclusions: This study created a framework of 10 priority areas to guide current and future efforts in diabetes translation research to achieve health equity. Themes rated as highly important and feasible provide the basis to evaluate current research support. Future efforts should explore how to best support innovative-targets, those rated highly important but less feasible