How Much Evidence Do We Need to Change Practices in Which We Firmly Believe?
Enough already! Randomized trials show that tight glucose control in patients with long-standing type 2 diabetes isn't beneficial.
Reduced Innervation of Sweat Glands in Diabetic Neuropathy
Neurology Summary and Comment
A novel technique to quantify nerves around sweat glands allows identification of reduced innervation in diabetic neuropathy that correlates with neuropathy severity.
By Claudia Sommer, MD
July 21, 2009
Covering:
Gibbons CH et al., Neurology 2009 Apr 28; 72:1479
Investigational Once-Daily Incretin Mimetic Outperforms Twice-Daily Exenatide
General Medicine Summary and Comment
In this study, liraglutide had clinical advantages and was more convenient to use.
By Bruce Soloway, MD
July 16, 2009
Covering:
Buse JB et al., Lancet 2009 Jul 4; 374:39
ACE Inhibitors and ARBs for Preventing Nephropathy and Retinopathy in Type 1 Diabetes
General Medicine Summary and Comment
Treatment did not prevent nephropathy but did prevent development of retinopathy.
By Jamaluddin Moloo, MD, MPH
July 14, 2009
Covering:
Mauer M et al., N Engl J Med 2009 Jul 2; 361:40
Perkins BA et al., N Engl J Med 2009 Jul 2; 361:83
Metabolic Changes in the Decade Before Diabetes
General Medicine Summary and Comment
Could very early intervention prevent progression to prediabetes?
By Bruce Soloway, MD
July 14, 2009
Covering:
Tabák AG et al., Lancet 2009 Jun 27; 373:2215
Cardiovascular Safety Data on Rosiglitazone Aren’t Entirely Reassuring
General Medicine Summary and Comment
Although few significant differences were detected in a large cohort at 5 years, excess heart failure risk still is apparent.
By Bruce Soloway, MD
July 9, 2009
Covering:
Home PD et al., Lancet 2009 Jun 20; 373:2125
Boning Up on Thiazolidinediones
Women's Health Summary and Comment
Rosiglitazone was associated with excess fracture risk in women.
Medicare Part D, Prescription Drug Spending, and Total Medical Spending
Cardiology Summary and Comment
In patients with little or no drug coverage before Part D enactment, additional drug costs during the program’s first 2 years were offset by reductions in other medical costs.
Scores Identify Patients at Risk for Diabetes
General Medicine Summary and Comment
One third to one half of people with the highest diabetes risk scores developed diabetes within 10 years.
Using HbA1c Assay for Diagnosis of Diabetes
Pediatrics and Adolescent Medicine Clinical Practice Guideline Watch
Free
Hemoglobin A1c levels are as accurate as glucose measurements for defining the level of hyperglycemia at which retinopathy begins.
By Howard Bauchner, MD
June 24, 2009
Covering:
Nathan DM et al. for the International Expert Committee., Diabetes Care 2009 Jun 5
Macrosomia and Gestational Diabetes: Big and Sweet Is Not a Good Combination
Birthweight
More Burn, Higher Return
Cardiology Summary and Comment
An increase in the prescribed energy expenditure of a cardiac rehabilitation program improved cardiac risk profiles.
By Joel M. Gore, MD
June 17, 2009
Covering:
Ades PA et al., Circulation 2009 May 11
Fenofibrate Might Reduce Amputations Caused by Microvascular Disease in Patients with Diabetes
General Medicine Summary and Comment
Free
Nontraumatic amputations occurred significantly less often in patients who take fenofibrate.
By Bruce Soloway, MD
June 11, 2009
Covering:
Rajamani K et al., Lancet 2009 May 23; 373:1780
Intensive Glucose Lowering and Adverse CV Outcomes in Patients with Type 2 Diabetes
General Medicine Summary and Comment
A meta-analysis suggests that intensive therapy beneficially affects rates of adverse coronary events but does not change rates of stroke or all-cause mortality during 10 years.
Rapid Weight Gain in Early Infancy Increases Risk for Cardiovascular Disease and Diabetes
Infants with rapid weight gain had significantly greater body fat and waist circumference and reduced insulin sensitivity as adults, compared with infants with slow weight gain.
Treating Diabetes and Coronary Artery Disease
Cardiology Summary and Comment
Free
Prompt revascularization or initial medical therapy? Insulin sensitization or provision? From the BARI 2D trial, no strategy emerged a clear winner.
By Harlan M. Krumholz, MD, SM
June 10, 2009
Covering:
Frye RL et al. for the BARI 2D Study Group., N Engl J Med 2009 Jun 11; 360:2503
Boden WE and Taggart DP., N Engl J Med 2009 Jun 11; 360:2570
Duration of Anticoagulation Therapy After Deep Venous Thrombosis
Cardiology Summary and Comment
In a randomized trial, the use of ultrasonography to guide treatment continuation reduced thrombosis recurrence.
By Joel M. Gore, MD
June 10, 2009
Covering:
Prandoni P et al., Ann Intern Med 2009 May 5; 150:577
Women and Nonobstructive Coronary Artery Disease
Cardiology Summary and Comment
More evidence that the presence of ischemic symptoms without underlying obstructive arteriostenosis warrants heightened vigilance, if not intervention
Gene Therapy for Diabetic Neuropathy
Neurology Summary and Comment
Free
Tentative evidence of the effectiveness of gene therapy with erythropoietin in an extensively studied animal model of diabetic neuropathy
By Allan H. Ropper, MD, FRCP
June 9, 2009
Covering:
Chattopadhyay M et al., Brain 2009 Apr; 132:879
Don’t Take Those Vitamins!
Psychiatry Summary and Comment
Free
Exercise promotes health, but vitamins C and E block this benefit.
By Jonathan Silver, MD
June 8, 2009
Covering:
Ristow M et al., Proc Natl Acad Sci U S A 2009 May 26; 106:8665
Hyperglycemia Can Increase Risk for Gastric Cancer
Gastroenterology Summary and Comment
Patients with both high HbA1c levels and <$EMPH_O>Helicobacter pylori<$EMPH_C> infection are at dramatically elevated risk.
Antioxidant Supplements Blunt Exercise-Induced Improvement of Insulin Sensitivity
General Medicine Summary and Comment
Free
Regardless of their previous exercise patterns, young men did not benefit from vitamin E or C supplementation.
General Medicine Summary and Comment
At 48 weeks, significantly more placebo recipients than voglibose recipients had progressed to diabetes.
By Bruce Soloway, MD
May 28, 2009
Covering:
Kawamori R et al., Lancet 2009 May 9; 373:1607
Scheen AJ., Lancet 2009 May 9; 373:1579
Staying Ahead of Diabetes Risk
Women's Health Summary and Comment
Healthy lifestyle factors were associated with substantially lower risk for new-onset diabetes in older adults.
Diabetes and Hypertension: Diseases Associated with Psoriasis
Dermatology Summary and Comment
Free
Two more systemic diseases are shown to be associated with psoriasis.
By Craig A. Elmets, MD
May 15, 2009
Covering:
Qureshi AA et al., Arch Dermatol 2009 Apr; 145:379
