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The number of e-prescriptions filled last year soared 181% to 191 million, according to "Advancing Healthcare in America," a report issued by Surescripts in Alexandria, Va.

As Americans increasingly turn to vitamins and herbal supplements as alternatives to prescription drug use, medical professionals and government leaders worry that few realize the implications.

At 5 years? follow-up, intensive blood-pressure reduction to a target systolic blood pressure (SBP) less than 120 mm Hg did not reduce the risk of a composite cardiovascular outcome, compared with a target SBP of less than 140 mm Hg in patients with type 2 diabetes at high risk of cardiovascular events, although it did reduce the incidence of stroke, said William Cushman, MD, who presented the results from the blood pressure portion of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study to a gathering at the 70th Scientific Sessions of the American Diabetes Association in Orlando, Fla.

Five-year data from a seminal study in patients with type 2 diabetes who are at especially high risk of heart disease show that intensive glucose control does slow the progression of microvascular disease, but mortality is increased and there is no benefit on macrovascular complications.

A new post-hoc study of rosiglitazone and cardiac events in patients with type 2 diabetes is adding to the controversy surrounding the thiazolidinedione (TZD) agent. Lead author Richard Bach, MD, associate professor of medicine, Washington University, St. Louis, Mo., presented the new data during a late-breaking clinical study symposium Tuesday morning at the 70th Scientific Sessions of the American Diabetes Association, taking place in Orlando, Fla.

Patients and providers who look for saccharine packets may like the product-or they may not realize the range of nonnutritive, noncaloric sweeteners currently available.

A community-based behavioral lifestyle intervention results in significant reductions in glycated hemoglobin, fasting blood glucose, and body weight in overweight/obese individuals with prediabetes, said David Goff Jr, MD, PHD.

Use of a sensor-augmented pump is superior to multiple daily insulin injections in reducing glycated hemoglobin levels without an increased risk of hypoglycemia in both adults and children with type 1 diabetes who are not in good control on multiple daily injections, said Richard M Bergenstal, MD.

Herbals and supplements such as silymarin (milk thistle), fish oil, and red rice yeast can improve some of the conditions associated with diabetes, but the evidence is slim.

In 1992, researcher Edwin Bierman, MD, described the development of cardiovascular disease in diabetes as a black box. Nearly 20 years later, it is still a black box.

A telemedicine intervention in older adults with diabetes improved hemoglobin (Hb) A1c levels, and this improvement in HbA1c was associated with more frequent uploading of glucose values, found Ruth Weinstock, MD, PhD, addressing a gathering at the 70th Scientific Sessions of the American Diabetes Association meeting in Orlando, Florida.

Obesity and leanness are more than calories in and energy out. The amount of adipose tissue an individual carries is also a function of his or her intestinal microbiota. Research in mice and humans suggests that individuals with more Firmicutes and fewer Bacteroidetes tend to be more obese.

Hypoglycemic episodes in type 2 diabetes predict discontinuation of oral antidiabetic drugs as well as higher costs of care.

In patients with diabetes and concomitant heart failure who are naive to oral antidiabetic drugs, the introduction of metformin use is associated with a lower risk of mortality than the introduction of other oral antidiabetic drugs, found Dean T Eurich, PhD.

Although their ability to control glycemia is essentially the same, do other merits of dipeptidyl peptidase 4 (DPP-4) inhibitors favor their replacing sulfonylureas in the treatment armamentarium for type 2 diabetes? Michael Nauck, MD, and David Matthews, FRCP, were on opposing sides of this issue.

Clinical reporting and coaching systems can significantly reduce glycated hemoglobin levels without increasing the costs of care.

Exercise research has found that boosting patients' self-determination is an effective way to improve their motivation to exercise.

A post hoc analysis of 5 clinical trials of liraglutide suggests that it was significantly better than active comparators on a composite end point of glycated hemoglobin less than 7% without hypoglycemia or weight gain, reported French investigators.

Fructose is the sugar consumers love to hate. It gets the blame for obesity, metabolic syndrome, and a variety of dietary ills. But according to at least one expert, the fructose content in high-fructose corn syrup just isn't that high.

In patients with type 2 diabetes, treatment with exenatide once weekly for 1 year results in sustained improvements in glycemic control, body weight, cardiovascular risk markers, and markers of hepatic injury, according to a pooled analysis of 2 large clinical trials.

An ancillary study to the ARIC (Atherosclerosis Risk in Communities) study supports the most recent (2010) ADA risk categories of glycated hemoglobin in identifying future risk of developing diabetes and macrovascular and microvascular disease.

Dietary choices can have a discernable effect on the risk of developing type 2 diabetes. That conclusion is based on analysis of men in the Health Professionals Follow-Up Study (HPFS), which followed 41,212 men for up to 20 years.

In clinical practice, exenatide is often started in patients with type 2 diabetes who are on insulin therapy, even though the prescribing information states that the concurrent use of exenatide with insulin has not been studied and cannot be recommended, according to analysis of a large nationwide database.

New data from Scotland suggest that drug regulators should change labeling on thiazolidinediones to warn of elevated risk for hip fractures in both men and women.

It was billed as a debate, but played as a mild disagreement. Should new diabetes drugs submitted to the FDA have a higher bar for cardiovascular safety than other drugs?

New data suggest that although diabetes doubles the risk of vascular disease, elevated fasting glucose has little effect on the risk of coronary heart disease or major ischemic events.

Too much high-density lipoprotein (HDL) cholesterol could be harmful for women with type 1 diabetes. Men with type 1 diabetes, however, continue to experience cardioprotection with increasing HDL, said Tina Costacou, PhD.

Patients who are not well controlled on metformin may get better control of glycated hemoglobin levels and weight using once-weekly exenatide than by titrating insulin glargine.

Liraglutide is more successful in reducing glycated hemoglobin levels to 7% or less regardless of baseline glycated hemoglobin level compared with sitagliptin in adults with type 2 diabetes, said Melanie Davies, MD, MB ChB, professor of diabetes medicine, University of Leicester, United Kingdom.

Patients treated over long periods with the diabetes drug metformin (Glucophage, Bristol-Myers Squibb) are at risk of developing vitamin-B12 deficiency, according to a study published in the British Medical Journal, Reuters has reported.