ADA 2008: Gut hormones key to appetite regulation
June 9th 2008Gut hormones play a key and often overlooked role in weight loss and weight regulation. Changes in weight are determined largely by the balance between energy intake and energy expenditure, but gut hormones can affect both sides of the energy equation.
ADA 2008: Endovascular interventions for PAD proliferate
June 9th 2008The range of endothelial interventions for peripheral artery disease (PAD) is proliferating. Today's choices include traditional balloon angioplasty, stents, drug eluting stents and fabric-covered stents. Newer technologies allow clinicians to cut out occlusions, freeze them, scrape them, laser them and kill them.
ADA 2008: Basal insulin plus pramlintide at mealtime controls glucose, with lower hypoglycemia risk
June 9th 2008Pramlintide injection added to basal insulin at mealtime is similar to titrated rapid-acting insulin in achieving glycemic control but with a lower risk of hypoglycemia and no weight gain in patients with type 2 diabetes, said Matthew Riddle, MD, head, section of diabetes, division of endocrinology/diabetes/clinical nutrition, Oregon Health and Sciences University, Portland.
ADA 2008: Surrogate endpoints in drug approval process examined, found wanting
June 9th 2008Surrogate endpoints in clinical trials (ie, hemoglobin [Hb] A1c) on which drug approvals may be based only explain narrow aspects of complex conditions. For this reason, even when using a drug as labeled, there is always a level of uncertainty over outcomes with the drug, said Saul Malozowski, MD, PhD, MPH.
ADA 2008: Be wary of trace element claims
June 9th 2008Clinicians should be wary of health claims made for trace elements such as iron or chromium. While there is no doubt that trace elements are needed for health, there is significant doubt about their utility in preventing or curing diabetes and other diseases, said Eliseo Guallar, MD, DrPH, Johns Hopkins Bloomberg School of Public Health, Baltimore. There are many hypotheses about the beneficial effects of trace elements, but little high-quality data, little reliable population data, few useful biomarkers, relatively crude analytical methods and few mechanistic studies.
ADA 2008: Separate drug classes prevent development of type 2 diabetes in susceptible patients
June 9th 2008Pioglitazone prevented progression to type 2 diabetes in patients with impaired glucose tolerance (IGT), reported Ralph DeFronzo, MD. The effect was marked?81% fewer patients assigned to pioglitazone compared with placebo converted from IGT to type 2 diabetes in a randomized, double-blind, placebo-controlled clinical study.
ADA 2008: UK study: Subpar glycemic control associated with poor pregnancy outcomes
June 8th 2008British women who have poorer glycemic control before and during pregnancy have poorer outcomes and less-healthy babies. That's the take home message from CEMACH, the Confidential Enquiry into Maternal and Child Health, a year-long survey of pregnant women with type 1 and type 2 diabetes across the United Kingdom.
ADA 2008: ACCORD trial reveals increased risk of death
June 8th 2008An intense glucose-lowering strategy in high-risk patients with type 2 diabetes was associated with an excess of mortality in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial, the U.S. counterpart to the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation) study.
ADA 2008: Novel agents for glycemic control are under investigation
June 8th 2008Several novel classes of agents designed to treat hyperglycemia are under investigation. These agents were the subjects of a symposium here. One such novel class is the sodium glucose co-transporter (SGLT) type 2 inhibitors, which reduce glucose levels by increasing kidney excretion of glucose. The kidney plays an important role in the handling of glucose, said Robert R. Henry, MD, professor of medicine and chief of VA endocrinology and metabolism at the University of California, San Diego. SGLT-2 is expressed almost exclusively in the kidney. About 90% of glucose reabsorption by the kidney is mediated by SGLT-2 under normal circumstances.
ADA 2008: Putting weight loss into clinical practice
June 8th 2008Translating weight loss research into clinical programs is not easy. Too many clinical protocols exist in isolation, according to Donald Williamson, PhD, Pennington Biomedical Research Center, Baton Rouge, LA. The key gap is extending methods that contribute to weight loss into programs that maintain weight loss.
ADA 2008: Human factors make or break continuous glucose monitoring
June 7th 2008Real-time continuous glucose monitoring (CGM) can significantly improve glycemic control, but it will not help all patients. "Real-time CGM will add significantly to glucose management for some people, but not for all," said Irl Hirsch, MD, University of Washington, Seattle. "Human factors make all the difference between success and failure. Some patients will never figure it out. That?s why real-time control is so challenging.