New Position Papers on Type 2 Diabetes Management
General Medicine Summary and Comment
Free
One document offers a sensible treatment algorithm; the other offers perspective on the relation between glycemic control and macrovascular complications.
By Allan S. Brett, MD
February 3, 2009
Covering:
Skyler JS et al., Diabetes Care 2009 Jan; 32:187
Nathan DM et al., Diabetes Care 2009 Jan; 32:193
Rosiglitazone, Pioglitazone, and Fractures: A Meta-Analysis
General Medicine Summary and Comment
Combined data from 10 trials show that rosiglitazone and pioglitazone confer significant risk for fractures.
Low-Glycemic-Index Diet and Diabetes
General Medicine Summary and Comment
Oatmeal was better than brown rice in lowering HbA1c .
Rosiglitazone vs. Pioglitazone: A Comparison of Cardiovascular Outcomes
Cardiology Summary and Comment
Results of a large observational study provide more evidence that rosiglitazone increases cardiovascular risk.
By Harlan M. Krumholz, MD, SM
January 7, 2009
Covering:
Winkelmayer WC et al., Arch Intern Med 2008 Nov 24; 168:2368
Nathan DM et al., Diabetes Care 2009 Jan; 32:193
Preventing Adverse Cardiovascular Events in Patients with Type 2 Diabetes
In younger patients with newly diagnosed diabetes, intensive glucose-lowering therapy appears to prevent macrovascular events; in patients with established diabetes, the jury is still out.
Intensive Glucose Lowering Does Not Cut CV Risks in Patients with Long-Standing Type 2 Diabetes
General Medicine Summary and Comment
Free
Results of a VA trial add to evidence produced by the ACCORD and ADVANCE trials.
Which Stent Type is Best for Patients with Diabetes?
Cardiology Summary and Comment
Three-year findings from a registry study suggest that DES are more effective than BMS are.
Drug-Eluting Stents vs. Coronary Artery Bypass Grafts in Patients with Diabetes
Cardiology Summary and Comment
Results of ARTS-II show a clear benefit of DES over BMS but are inconclusive on the equivalence of DES and CABG.
Does Glucose Control in Type 2 Diabetes Affect Cardiovascular Risk?
Cardiology Summary and Comment
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Results from another late-intervention study show no significant effect at about 6 years of follow-up.
Ethnicity and Incidence of Congestive Heart Failure
Cardiology Summary and Comment
In a large U.S. cohort study, higher incidence of CHF in blacks than in other ethnic groups was largely explained by higher rates of diabetes and hypertension.
By Joel M. Gore, MD
December 10, 2008
Covering:
Bahrami H et al., Arch Intern Med 2008 Oct 27; 168:2138
Antiplatelet Therapy for Patients with Diabetes: More Is Better
Cardiology Summary and Comment
In patients with ACS, the net clinical benefit of prasugrel, compared with clopidogrel, was greater for those who had diabetes than for those who didn’t.
By Howard C. Herrmann, MD
December 3, 2008
Covering:
Wiviott SD et al. for the TRITON-TIMI 38 Investigators., Circulation 2008 Oct 14; 118:1626
Fuster V and Farkouh ME., Circulation 2008 Oct 14; 118:1607
Metformin-Associated Lactic Acidosis Reexamined
General Medicine Summary and Comment
In this study, lactic acidosis was not more common with metformin than with sulfonylurea.
By Allan S. Brett, MD
November 26, 2008
Covering:
Bodmer M et al., Diabetes Care 2008 Nov; 31:2086
A One-Two Punch for Coronary Risk in Patients with Diabetes
Cardiology Summary and Comment
Findings from a case–control and independent-cohort study suggest that genotype and poor glycemic control interact to predict CAD in diabetic patients.
Diabetes Treatment and Alzheimer Pathology
Neurology Summary and Comment
Free
Do hypoglycemic agents directly alter neuritic plaques or contribute to dementia in another way?
By David A. Wolk, MD
November 25, 2008
Covering:
Beeri MS et al., Neurology 2008 Sep 2; 71:750
Can Renin-Angiotensin Blockade Prevent Diabetic Retinopathy?
General Medicine Summary and Comment
Free
Three 5-year trials yielded negative results for candesartan.
By Bruce Soloway, MD
November 20, 2008
Covering:
Sjølie AK et al., Lancet 2008 Oct 18; 372:1385
Chaturvedi N et al., Lancet 2008 Oct 18; 372:1394
Insulins: Many Options, Few Differences
General Medicine Summary and Comment
Researchers compared various forms of insulin and its analogues.
By Richard Saitz, MD, MPH, FACP, FASAM
November 18, 2008
Covering:
Esposito K et al., Ann Intern Med 2008 Oct 21; 149:531
Qayyum R et al., Ann Intern Med 2008 Oct 21; 149:549
Majumdar S and Barrett E., Ann Intern Med 2008 Oct 21; 149:586
No Benefit for Aspirin in Diabetic Patients Without Symptomatic CVD
General Medicine Summary and Comment
However, diabetic patients with established cardiovascular disease should still take aspirin for secondary prevention.
Aspirin, Cardiovascular Disease, and Type 2 Diabetes
General Medicine Summary and Comment
Aspirin showed no benefit for preventing CVD events, but some caveats remain about these results.
By Thomas L. Schwenk, MD
November 13, 2008
Covering:
Ogawa H et al., JAMA 2008 Nov 12; 300:2134
Nicolucci A., JAMA 2008 Nov 12; 300:2180
Does Aspirin Prevent Cardiovascular Events in Patients with Diabetes?
Cardiology Summary and Comment
No benefit was found in a randomized trial in Japan, but the study was underpowered, and the results are inconclusive.
By JoAnne M. Foody, MD
November 13, 2008
Covering:
Ogawa H et al. for the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) Trial Investigators., JAMA 2008 Nov 12; 300:2134
Aspirin or Antioxidants for Primary Prevention? Not so Fast!
Cardiology Summary and Comment
In a randomized, controlled trial, neither strategy conferred any benefit in patients with diabetes and asymptomatic peripheral arterial disease.
By Beat J. Meyer, MD
November 13, 2008
Covering:
Belch J et al., BMJ 2008 Oct 16; 337:a1840
Hiatt WR., BMJ 2008 Oct 16; 337:a1806
Meta-Analysis of Oral Agents for Diabetes Shows Weakness of the Literature
Cardiology Summary and Comment
Many published studies have yielded little useful data on cardiovascular outcomes.
Bisphenol A: An Environmental Risk Factor for Cardiovascular Disease?
Cardiology Summary and Comment
In a cross-sectional analysis, high urine concentrations of a commonly used industrial chemical were associated with diabetes and coronary events.
The Influence of Body Weight and C-Peptide Levels on Prostate Cancer Mortality
Elevated prediagnostic measures of both factors were independent predictors of disease-specific death.
Do More Data Translate into Better Control of Diabetes During Pregnancy?
Women's Health Summary and Comment
Intermittent use of continuous glucose monitoring by pregnant women with diabetes seemed to help them achieve glycemic control and lower risk for fetal macrosomia.
By Wendy S. Biggs, MD
October 23, 2008
Covering:
Murphy HR et al., BMJ 2008 Sep 25; 337:a1680
Another Treatment for Type 1 Diabetes
In children with newly diagnosed type 1 diabetes, injections with the autoantigen glutamic acid decarboxylase slowed insulin secretion without significant adverse effects.
By Howard Bauchner, MD
October 22, 2008
Covering:
Ludvigsson J et al., N Engl J Med 2008 Oct 30; 359:1909
Faustman DL., N Engl J Med 2008 Oct 30; 359:1956
