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 | UTCStudy 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.
Crossover RCT | Using one-size cuff results in major inaccuracy in BP readings across varying arm sizes
11 Aug, 2023 | 15:41h | UTCEffects 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:
Commentary on Twitter
Using a regular blood pressure (BP) cuff regardless of individual’s arm size resulted in 3.6 mmHg lower systolic BP when a regular cuff was one size too-large, and 4.8 and 19.5 mmHg higher when a regular cuff was one and two sizes too small. https://t.co/ZKnGfWc9fy
— JAMA Internal Medicine (@JAMAInternalMed) August 7, 2023
Perspective | Clinicians debate the usefulness of NAFLD name change
11 Aug, 2023 | 15:39h | UTCClinicians 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 | UTCStudies 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 | UTCCommentaries:
SELECT: Semaglutide Cuts CV Events in Adults With Overweight or Obesity – TCTMD
Cohort Study | Vegetarian diet linked to elevated hip fracture risk; BMI plays a partial role
9 Aug, 2023 | 15:16h | UTC
Multinational Study | No correlation between Covid-19 and onset of type 1 diabetes in children
8 Aug, 2023 | 13:32h | UTC
Cohort Study | Habitual calcium supplementation linked to higher CVD incidence and mortality in diabetics
8 Aug, 2023 | 13:24h | UTCAssociations 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)
Commentary on Twitter
Habitual Ca supplementation was associated with higher risks of CVD in diabetics but not non-diabetics, suggesting that diabetics may need to be cautious about the long-term use of Ca supplements. @ADA_Pubs
Read Here➡️https://t.co/wUBy6KJhaw pic.twitter.com/6FXmwBwnMS
— Diabetes Care, a research journal of the ADA ? (@DiabetesCareADA) July 28, 2023
Do-it-yourself automated insulin delivery: a health-care practitioner user’s guide
7 Aug, 2023 | 14:44h | UTC
Review | Diabetes of the exocrine pancreas: implications for pharmacological management
7 Aug, 2023 | 14:25h | UTCDiabetes of the Exocrine Pancreas: Implications for Pharmacological Management – Drugs
Review | Primary aldosteronism: a pragmatic approach to diagnosis and management
4 Aug, 2023 | 12:06h | UTCPrimary 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
Review | Non-alcoholic fatty liver disease: pathophysiological concepts and treatment options
1 Aug, 2023 | 14:19h | UTCRelated:
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
Management of NAFLD in primary care settings – Liver International
Non-alcoholic fatty liver disease: A patient guideline – JHEP Reports
Review | Vegetarian and vegan diets: benefits and drawbacks
1 Aug, 2023 | 14:11h | UTCVegetarian and vegan diets: benefits and drawbacks – European Heart Journal (free for a limited period)
Commentary on Twitter
Vegetarian and vegan diets: benefits and drawbacks https://t.co/6XtpEH1RKV @escardio #EHJ #ESCYoung @rladeiraslopes @ehj_ed pic.twitter.com/zAQHJdKpCL
— European Society of Cardiology Journals (@ESC_Journals) July 31, 2023
Observational Study | More data suggesting Rosuvastatin 10mg/Ezetimibe 10mg combo may be an alternative to Rosuvastatin 20mg
31 Jul, 2023 | 14:38h | UTCCombination 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
Commentary on Twitter
The current observational analysis assessed the clinical impact of 2 strategies (moderate-intensity statin therapy/ezetimide compared to high-intensity statin monotherapy) among patients undergoing PCI in the Korean nationwide cohort database. https://t.co/liOwFt1NHR #JACC pic.twitter.com/zM4vJhR3id
— American College of Cardiology (@ACCinTouch) July 29, 2023
WHO updates guidelines on fats and carbohydrates
28 Jul, 2023 | 14:25h | UTCNews Release: WHO updates guidelines on fats and carbohydrates – World Health Organization
Guidelines:
Carbohydrate intake for adults and children: WHO guideline – World Health Organization
Commentary on Twitter (thread – click for more)
Avoid #TransFats! Trans fats are found in
?️ baked & fried foods,
?️ pre-packaged snacks,
?️ meat & dairy foods from animals such as cows or sheep,
?️ processed foods.Limit your trans fats intake to less than 1% of total energy intake ?https://t.co/vCZlOtUeLj #HealthyDiets pic.twitter.com/l0ErFXvO4Q
— World Health Organization (WHO) (@WHO) July 17, 2023
Study | New deep learning model effectively detects type 2 diabetes from chest X-rays
28 Jul, 2023 | 14:15h | UTC
Commentary on Twitter
"Your Chest-ray indicates you may have diabetes"https://t.co/1TEHWvG33D
The latest unexpected outgrowth of deep learning #AI @NatureComms @AyisPyrros and colleagues pic.twitter.com/wZcTT2GCy2— Eric Topol (@EricTopol) July 11, 2023
Cohort Study | Exploring the potential impact of artificial sweeteners on type 2 diabetes risk
28 Jul, 2023 | 14:07h | UTC
RCT | Liraglutide aids weight management in patients with suboptimal weight loss post metabolic surgery
28 Jul, 2023 | 14:05h | UTCSee also: Visual Abstract
RCT – 2ry Analysis | Elevated intracranial bleeding risk with low-dose aspirin in older adults
27 Jul, 2023 | 13:09h | UTCSee 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: Efficacy and Safety of Aspirin for Primary Prevention of Cardiovascular Events
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 | UTCNews 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 | UTCPitavastatin 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
Original Article: Pitavastatin to Prevent Cardiovascular Disease in HIV Infection https://t.co/HuR0Lt24N5
Editorial: HIV and Cardiovascular Disease — An Ounce of Prevention https://t.co/fsxCqrLKi0#IAS2023 pic.twitter.com/TCSQkJQNYa
— NEJM (@NEJM) July 24, 2023
Cohort Study | More data suggests SGLT-2 inhibitors could reduce gout flares
26 Jul, 2023 | 13:24h | UTCComparative 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 | UTCCommentary: M-A: Vegetarian diets may modestly improve cardiometabolic profile in high-risk individuals – HCP Live