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Endocrinology (all articles)

RCT: No difference in ICU length of stay or 90-day mortality between tight and liberal glucose control

2 Oct, 2023 | 11:25h | UTC

Study Design and Population: This randomized controlled trial assessed the effects of tight versus liberal glucose control on the length of ICU stay in critically ill patients. A total of 9,230 patients were included, with 4,622 in the liberal-control group (insulin initiation when blood glucose levels exceeded 215 mg/dL) and 4,608 in the tight-control group (blood glucose targeted between 80 and 110 mg/dL). In both groups, parenteral nutrition was withheld during the first week of ICU admission. The primary endpoint was the duration of ICU stay, and 90-day mortality served as a key safety outcome.

Main Findings: No significant differences were observed in the primary endpoint, the length of ICU stay, between the two groups (hazard ratio 1.00; 95% CI, 0.96 to 1.04; P=0.94). The 90-day mortality rates were also similar (10.1% in the liberal-control group vs. 10.5% in the tight-control group, P=0.51). Incidences of severe hypoglycemia were low and statistically similar in both groups (1.0% in the tight-control group vs. 0.7% in the liberal-control group). Secondary outcomes, including new infections and the duration of respiratory and hemodynamic support, showed no significant differences. However, lower incidences of severe acute kidney injury and cholestatic liver dysfunction were observed in the tight-control group.

Implications & Limitations: The study supports existing evidence that tight glucose control doesn’t provide substantial benefits in reducing ICU stay duration or mortality. This suggests that a more liberal approach to glucose control may be preferable in most ICU settings, especially to minimize hypoglycemia risk. Key limitations of the study include its narrow focus on the absence of early parenteral nutrition, which could limit generalizability, and the inability to blind caregivers to treatment assignments. Future research should investigate the impact of tight glucose control in various patient subgroups and under different nutritional conditions.

Article: Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU – New England Journal of Medicine

 


Crossover RCT | Using one-size cuff results in major inaccuracy in BP readings across varying arm sizes

11 Aug, 2023 | 15:41h | UTC

Effects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial – JAMA Internal Medicine (free for a limited period)

Commentaries:

When it comes to blood pressure cuffs, size matters – MedicalResearch.com

One-size-fits-all blood pressure cuffs ‘strikingly inaccurate,’ study says – CNN

Related:

Brief Review | Why is cuff size so important and other factors that affect accurate blood pressure measurement

[News release – not published yet] Study finds blood pressure cuff size matters, affects blood pressure readings

 

Commentary on Twitter

 


Perspective | Clinicians debate the usefulness of NAFLD name change

11 Aug, 2023 | 15:39h | UTC

Clinicians debate the usefulness of NAFLD name change – MDedge

Original article: From NAFLD to MASLD | New consensus changes fatty liver disease terminology to avoid stigmatization

 


Presented at ASRS Meeting | Studies link GLP-1 agonists to progression of diabetic retinopathy

11 Aug, 2023 | 15:38h | UTC

Studies link GLP-1 agonists to progression of diabetic retinopathy – MDedge

 


[News Release] RCT | Semaglutide 2.4 mg reduces cardiovascular risk by 20% in adults with CVD & obesity

9 Aug, 2023 | 15:40h | UTC

Novo Nordisk A/S: Semaglutide 2.4 mg reduces the risk of major adverse cardiovascular events by 20% in adults with overweight or obesity in the SELECT trial – Novo Nordisk

Commentaries:

SELECT: Semaglutide Cuts CV Events in Adults With Overweight or Obesity – TCTMD

Expert reaction to Novo Nordisk press release announcing the headline results from their SELECT cardiovascular outcomes semaglutide trial – Science Media Centre

Related: Role of Glucagon‐Like Peptide‐1 Receptor Agonists in Achieving Weight Loss and Improving Cardiovascular Outcomes in People With Overweight and Obesity – Journal of the American Heart Association

 


Cohort Study | Vegetarian diet linked to elevated hip fracture risk; BMI plays a partial role

9 Aug, 2023 | 15:16h | UTC

Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: a prospective cohort study of 413,914 UK Biobank participants – BMC Medicine

 


Multinational Study | No correlation between Covid-19 and onset of type 1 diabetes in children

8 Aug, 2023 | 13:32h | UTC

SARS-CoV-2 — No Increased Islet Autoimmunity or Type 1 Diabetes in Teens – New England Journal of Medicine

 


Cohort Study | Habitual calcium supplementation linked to higher CVD incidence and mortality in diabetics

8 Aug, 2023 | 13:24h | UTC

Associations of Habitual Calcium Supplementation With Risk of Cardiovascular Disease and Mortality in Individuals With and Without Diabetes – Diabetes Care (link to abstract – $ for full-text)

Related: The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials – Journal of the American College of Nutrition

 

Commentary on Twitter

 


Do-it-yourself automated insulin delivery: a health-care practitioner user’s guide

7 Aug, 2023 | 14:44h | UTC

Do-It-Yourself Automated Insulin Delivery: A Health-care Practitioner User’s Guide – Canadian Journal of Diabetes

 


Review | Diabetes of the exocrine pancreas: implications for pharmacological management

7 Aug, 2023 | 14:25h | UTC

Diabetes of the Exocrine Pancreas: Implications for Pharmacological Management – Drugs

 


Review | Primary aldosteronism: a pragmatic approach to diagnosis and management

4 Aug, 2023 | 12:06h | UTC

Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management – Mayo Clinic Proceedings

 


Brief Review | How do I diagnose and treat my patient’s amiodarone-induced thyrotoxicosis?

4 Aug, 2023 | 11:52h | UTC

How do I diagnose and treat my patient’s amiodarone-induced thyrotoxicosis? – Cleveland Clinic Journal of Medicine

 


Review | Non-alcoholic fatty liver disease: pathophysiological concepts and treatment options

1 Aug, 2023 | 14:19h | UTC

Non-alcoholic fatty liver disease: pathophysiological concepts and treatment options – Cardiovascular Research

Related:

From NAFLD to MASLD | New consensus changes fatty liver disease terminology to avoid stigmatization

Nonalcoholic fatty liver disease from a primary care perspective – Diabetes, Obesity and Metabolism

AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease – Hepatology

Management of NAFLD in primary care settings – Liver International

Updated S2k Clinical Practice Guideline on Non-alcoholic Fatty Liver Disease (NAFLD) issued by the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) – Zeitschrift für Gastroenterologie

AGA Clinical Practice Update | Diagnosis and management of nonalcoholic fatty liver disease in lean individuals.

Quality standards for the management of non-alcoholic fatty liver disease (NAFLD): consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology NAFLD Special Interest Group – The Lancet Gastroenterology & Hepatology (free registration required)

Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A Scientific Statement From the American Heart Association – Arteriosclerosis, Thrombosis, and Vascular Biology

Advancing the global public health agenda for NAFLD: a consensus statement – Nature Reviews Gastroenterology & Hepatology

Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease – Gastroenterology

Non-alcoholic fatty liver disease: A patient guideline – JHEP Reports

 


Review | Vegetarian and vegan diets: benefits and drawbacks

1 Aug, 2023 | 14:11h | UTC

Vegetarian and vegan diets: benefits and drawbacks – European Heart Journal (free for a limited period)

 

Commentary on Twitter

 


Observational Study | More data suggesting Rosuvastatin 10mg/Ezetimibe 10mg combo may be an alternative to Rosuvastatin 20mg

31 Jul, 2023 | 14:38h | UTC

Combination Lipid-Lowering Therapy in Patients Undergoing Percutaneous Coronary Intervention – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentaries:

Statins post PCI: Moderate intensity plus ezetimibe may be preferable – Cardiology News

Combination Lipid-Lowering Therapy After PCI – American College of Cardiology

Related: Open-label RCT | Moderate-intensity statin plus ezetimibe is noninferior to high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease.

 

Commentary on Twitter

 


WHO updates guidelines on fats and carbohydrates

28 Jul, 2023 | 14:25h | UTC

News Release: WHO updates guidelines on fats and carbohydrates – World Health Organization

Guidelines:

Saturated fatty acid and trans-fatty acid intake for adults and children: WHO guideline – World Health Organization

Total fat intake for the prevention of unhealthy weight gain in adults and children: WHO guideline – World Health Organization

Carbohydrate intake for adults and children: WHO guideline – World Health Organization

 

Commentary on Twitter (thread – click for more)

 


Study | New deep learning model effectively detects type 2 diabetes from chest X-rays

28 Jul, 2023 | 14:15h | UTC

Opportunistic detection of type 2 diabetes using deep learning from frontal chest radiographs – Nature Communications

 

Commentary on Twitter

 


Cohort Study | Exploring the potential impact of artificial sweeteners on type 2 diabetes risk

28 Jul, 2023 | 14:07h | UTC

Artificial Sweeteners and Risk of Type 2 Diabetes in the Prospective NutriNet-Santé Cohort – Diabetes Care

 


RCT | Liraglutide aids weight management in patients with suboptimal weight loss post metabolic surgery

28 Jul, 2023 | 14:05h | UTC

Safety and Efficacy of Liraglutide, 3.0 mg, Once Daily vs Placebo in Patients With Poor Weight Loss Following Metabolic Surgery: The BARI-OPTIMISE Randomized Clinical Trial – JAMA Surgery

See also: Visual Abstract

 


RCT – 2ry Analysis | Elevated intracranial bleeding risk with low-dose aspirin in older adults

27 Jul, 2023 | 13:09h | UTC

Low-Dose Aspirin and the Risk of Stroke and Intracerebral Bleeding in Healthy Older People: Secondary Analysis of a Randomized Clinical Trial – JAMA Network Open

See also: Visual Abstract

News Release: Low dose aspirin won’t help some older adults trying to avoid a stroke: study – Monash University

Commentary: Daily aspirin doesn’t prevent strokes in older, healthy people after all – The Conversation

Original Study: Randomized Trial: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly

Related Guideline: USPSTF Recommendation Statement: Aspirin Use to Prevent Cardiovascular Disease.

Related Randomized Trials:

Randomized Trial: Aspirin for Primary Prevention of Cardiovascular Disease

Randomized Trial: Effects of Aspirin for Primary Prevention in Persons with Diabetes

Related Meta-Analysis:

Meta-Analysis: Association of Aspirin Use for Primary Prevention with Cardiovascular Events and Bleeding Events

Meta-Analysis: Efficacy and Safety of Aspirin for Primary Prevention of Cardiovascular Events

Aspirin for primary prevention of cardiovascular disease: a meta-analysis with a particular focus on subgroups – BMC Medicine

Related Opinions:

Aspirin for Primary Prevention: Is This the End of the Road?

Evidence evolving on aspirin as prevention – ACP Internist

#347 USPSTF Update: Aspirin for Primary Prevention of CVD – The Curbsiders

 


Scientific Statement | Addressing childhood obesity to reduce adult CV risk through lifestyle

27 Jul, 2023 | 13:03h | UTC

Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood: a joint scientific statement of the task force for childhood health of the European Association of Preventive Cardiology and the European Childhood Obesity Group – European Journal of Preventive Cardiology

News Release: How to stop obese children having heart disease in adulthood – European Society of Cardiology

 


Podcast | Obesity medicine, GLP1 agonists, weight loss management tools and tips

27 Jul, 2023 | 12:55h | UTC

#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips – The Curbsiders

 


RCT | Pitavastatin effective in the primary prevention of cardiovascular disease in HIV-infected individuals

26 Jul, 2023 | 13:35h | UTC

Pitavastatin to Prevent Cardiovascular Disease in HIV Infection – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

Pitavastatin lowers risk of cardiovascular events in people living with HIV – Aidsmap

Statins reduce cardiovascular risk in people living with HIV, new global study finds – STAT

Pitavastatin Cuts MACE in HIV-Infected Patients: REPRIEVE – TCTMD

 

Commentary on Twitter

 


Cohort Study | More data suggests SGLT-2 inhibitors could reduce gout flares

26 Jul, 2023 | 13:24h | UTC

Comparative Effectiveness of Sodium–Glucose Cotransporter-2 Inhibitors for Recurrent Gout Flares and Gout-Primary Emergency Department Visits and Hospitalizations: A General Population Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries:

SGLT-2 inhibitors reduced gout flares in patients with diabetes, gout – ACP Internist

SGLT2i Use Linked to Reduced Risk for Flare in Adults With Gout, T2D – HealthDay

SGLT2 inhibitors linked with fewer gout flares in diabetes – MDedge

 


M-A | Vegetarian diets may modestly improve cardiometabolic profile in high-risk individuals

26 Jul, 2023 | 13:15h | UTC

Vegetarian Dietary Patterns and Cardiometabolic Risk in People With or at High Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis – JAMA Network Open

Commentary: M-A: Vegetarian diets may modestly improve cardiometabolic profile in high-risk individuals – HCP Live

 


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