Diabetes | Links Medicus Content Curation & Alerts in Medicine

Summary: The study enrolled 102 young children between ages 2 and 5, randomized in a 2:1 ratio to either a closed-loop control system of insulin delivery (“artificial pancreas”) or a standard care comparison group. During the 13 weeks of study follow-up, participants in the artificial pancreas group spent 12% more time within their target blood glucose range compared to the standard care group.

The closed-loop group experienced two cases of severe hypoglycemia, while the standard-care group had one case. In the closed-loop group, one case of diabetic ketoacidosis occurred due to a problem with the insulin pump.

Article: Trial of Hybrid Closed-Loop Control in Young Children with Type 1 Diabetes – New England Journal of Medicine (link to abstract – $ for full-text)

News Releases:

Artificial Pancreas Developed at UVA Improves Blood Sugar Control for Kids Ages 2-6, Study Finds – University of Virginia

NIH-supported trial shows artificial pancreas improves blood glucose control in young children – National Institutes of Health

Commentary on Twitter

In children 2 to younger than 6 years of age with type 1 diabetes, a closed-loop control system was associated with a greater percentage of time in the target glycemic range than standard care. https://t.co/rAOLXRNuub #pediatrics #T1D pic.twitter.com/Nzwl3aFr1w

— NEJM (@NEJM) March 17, 2023

M-A | Global prevalence of diabetic retinopathy in pediatric type 2 diabetes

20 Mar, 2023 | 13:12h | UTC

Global Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis – JAMA Network Open

Post-hoc analysis | Could SGLT2 inhibitors have a beneficial effect on gout symptoms?

17 Mar, 2023 | 13:02h | UTC

Association of Dapagliflozin Use With Clinical Outcomes and the Introduction of Uric Acid–Lowering Therapy and Colchicine in Patients With Heart Failure With and Without GoutA Patient-Level Pooled Meta-analysis of DAPA-HF and DELIVER – JAMA Cardiology

RCT | Insulin degludec is noninferior to insulin detemir for the treatment of pregnant women with type 1 diabetes

16 Mar, 2023 | 12:59h | UTC

Insulin degludec versus insulin detemir, both in combination with insulin aspart, in the treatment of pregnant women with type 1 diabetes (EXPECT): an open‑label, multinational, randomised, controlled, non-inferiority trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

The global burden of metabolic disease: data from 2000 to 2019

13 Mar, 2023 | 14:39h | UTC

The global burden of metabolic disease: Data from 2000 to 2019 – Cell Metabolism (free for a limited period)

Current recommendations for management of pediatric diabetic ketoacidosis

10 Mar, 2023 | 14:38h | UTC

Current recommendations for management of paediatric diabetic ketoacidosis – Canadian Pediatric Society

Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland

3 Mar, 2023 | 13:51h | UTC

Summary: The study aimed to determine the association between maternal diabetes and overweight/obesity and the risk of congenital heart defects (CHDs) in offspring. The study analyzed data from all children born in Finland between 2006 and 2016 and their mothers. Maternal type 1 diabetes (T1DM) was found to be associated with a significantly increased risk for any CHD, with an odds ratio of 3.71, whereas maternal overweight and obesity were associated with only a slightly increased risk for complex defects and left ventricular outflow tract obstruction. Maternal diabetes was responsible for 3.0% of offspring’s CHD, while maternal overweight and obesity were responsible for 0.7%, indicating weaker associations between maternal overweight and obesity and CHD in the offspring than previously reported.

[Preprint] Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland – medRxiv

Commentary from the author on Twitter

Proudly presenting our preprint (thread):

Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland https://t.co/rFnlNYPrgn 1/7

— Emmi Helle (@EmmiHelle) February 27, 2023

Youth-onset type 2 diabetes: the epidemiology of an awakening epidemic

2 Mar, 2023 | 13:01h | UTC

Youth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic – Diabetes Care

RCT | Empagliflozin (SGLT2i) is more effective for reducing HbA1c than linagliptin (DPP-4i) in young people with Type 2 DM

2 Mar, 2023 | 13:00h | UTC

Efficacy and safety of the SGLT2 inhibitor empagliflozin versus placebo and the DPP-4 inhibitor linagliptin versus placebo in young people with type 2 diabetes (DINAMO): a multicentre, randomised, double-blind, parallel group, phase 3 trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

Commentaries:

DINAMO: Empagliflozin shows promise for young people with type 2 diabetes – medwire News

Phase 3 trial finds oral empagliflozin provides safe glycemic control in children with type 2 diabetes – Joslin Diabetes Center

M-A | Combination of multiple low-risk lifestyle behaviors and incident type 2 diabetes

1 Mar, 2023 | 14:06h | UTC

Summary: This systematic review and meta-analysis assessed the association between multiple low-risk lifestyle behaviors (LRLBs) and the incidence of type 2 diabetes. The study examined 30 cohort comparisons involving 1,693,753 participants and 75,669 cases of type 2 diabetes. The LRLBs evaluated in the study were maintaining a healthy body weight, healthy diet, regular exercise, smoking abstinence or cessation, and light alcohol consumption. Results showed that the highest adherence to these LRLBs was associated with an 80% lower risk of type 2 diabetes compared to the lowest adherence group. Thus, targeting these LRLBs could be an effective strategy for the primary prevention of type 2 diabetes. However, the authors recommend promoting only four LRLBs, excluding alcohol intake, due to its association with increased harm. The potential benefits of small alcohol intake remain a controversial issue since most studies on the subject are observational and subject to residual confounding.

Article: Combination of Multiple Low-Risk Lifestyle Behaviors and Incident Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies – Diabetes Care (free for a limited period)

Commentary from the author on Twitter (thread – click for more)

Our research shows that adherence to multiple low-risk lifestyle behaviours including healthy diet and exercise can significantly reduce the risk of type 2 diabetes https://t.co/mWEEw9xYtQ #healthylifestyle #lowriskhabits #healthresearch

— Tauseef Khan (@tauseefkhan) February 22, 2023

RCT | Physician-led medication reviews in polypharmacy patients with Type 2 DM treated with at least 12 medications

1 Mar, 2023 | 13:36h | UTC

Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic: a randomised trial – Diabetic Medicine

Review | Embracing complexity: making sense of diet, nutrition, obesity and type 2 diabetes

28 Feb, 2023 | 13:42h | UTC

Embracing complexity: making sense of diet, nutrition, obesity and type 2 diabetes – Diabetologia

Commentary on Twitter

Comprehensive Review @DiabetologiaJnl by my very talented friend Prof Nita Forouhi

Embracing complexity: making sense of diet, nutrition, obesity & T2 diabeteshttps://t.co/PxGOZL0XkB pic.twitter.com/x2GaDPClfi

— Prof Kamlesh Khunti (@kamleshkhunti) February 24, 2023

Under a http://creativecommons.org/licenses/by/4.0/ license

RCT | Tight glycemic control did not preserve pancreatic beta cell function in newly diagnosed pediatric type 1 diabetes

27 Feb, 2023 | 13:16h | UTC

Summary: The study aimed to determine if intensive diabetes management with an automated insulin delivery system could help preserve pancreatic beta cell function in youth with newly diagnosed type 1 diabetes. The randomized clinical trial included 113 youths aged 7 to 17 years and found that although the mean time in the target range of 70 to 180 mg/dL was 78% in the intensive management group vs. 64% in the standard care group, intensive diabetes management did not affect the decline in pancreatic C-peptide secretion at 52 weeks. The study concluded that near normalization of glucose levels instituted immediately after diagnosis of type 1 diabetes did not preserve pancreatic beta cell function in youth.

Article: Effect of Tight Glycemic Control on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Preserving Pancreatic Beta Cell Function in Recent-Onset Type 1 Diabetes – JAMA (free for a limited period)

Commentary on Twitter

Intensive diabetes management with automated insulin delivery did not affect the decline in pancreatic C-peptide secretion at 52 weeks in youths with newly diagnosed type 1 diabetes. https://t.co/e1n5xagrtv #ATTD2023 pic.twitter.com/C6743BmqyH

— JAMA (@JAMA_current) February 24, 2023

RCT | Verapamil partially preserved pancreatic beta cell function in newly diagnosed pediatric type 1 diabetes

27 Feb, 2023 | 13:14h | UTC

Summary: The study aimed to determine whether verapamil could preserve pancreatic beta cell function in children and adolescents with newly diagnosed type 1 diabetes. The randomized clinical trial involved 88 participants who were given either verapamil or placebo once daily for 52 weeks. The study found that C-peptide levels were 30% higher in the verapamil group compared to the placebo group at 52 weeks, and the percentage of participants with a 52-week peak C-peptide level of 0.2 pmol/mL or greater was 95% in the verapamil group compared to 71% in the placebo group. The study also found that verapamil was well tolerated with few adverse events. The results suggest that verapamil may partially preserve stimulated C-peptide secretion in children and adolescents with newly diagnosed type 1 diabetes. However, further studies with patient-relevant outcomes are needed to determine the long-term effectiveness and the optimal length of therapy.

Article: Effect of Verapamil on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Preserving Pancreatic Beta Cell Function in Recent-Onset Type 1 Diabetes – JAMA (free for a limited period)

News Release: Verapamil shows beneficial effect on the pancreas in children with newly-diagnosed type 1 diabetes – University of Minnesota

Commentary on Twitter

In youth with newly diagnosed type 1 diabetes, verapamil partially preserved stimulated C-peptide secretion at 52 weeks from diagnosis compared with placebo. https://t.co/m4xbczf93C #ATTD2023 pic.twitter.com/teM0jjh1tT

— JAMA (@JAMA_current) February 24, 2023

Cohort Study | Association of large-for-gestational age birth and prediabetes/diabetes 10-14 years’ postpartum

24 Feb, 2023 | 13:43h | UTC

Summary: Several studies show that women who develop diabetes during pregnancy are at increased risk of developing diabetes later in life. This study investigated whether giving birth to a larger-than-normal baby is associated with an increased risk of prediabetes or diabetes 10-14 years after pregnancy in individuals without gestational diabetes. The study used data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study, including pregnant individuals without gestational diabetes. After adjusting for various baseline maternal characteristics, the researchers found that individuals who gave birth to a large-for-gestational age (LGA) infant had a 21% higher risk of being diagnosed with prediabetes or diabetes 10-14 years after delivery compared to those who had an appropriate-for-gestational age (AGA) infant. The study concluded that having a previous LGA infant is a marker of increased risk of developing prediabetes or diabetes in individuals without gestational diabetes.

Abstract: Association of large-for-gestational age birth and prediabetes/diabetes 10-14 years’ postpartum in the HAPO follow-up study – American Journal of Obstetrics & Gynecology (link to abstract, presented at the Society for Maternal-Fetal Medicine’s annual meeting)

News Release: New study reveals pregnant people who deliver large babies are at increased risk of developing diabetes later in life – Society for Maternal-Fetal Medicine

Commentaries:

Delivering a Plus-Sized Baby Could Be Sign of Diabetes Risk – HealthDay

Large for Gestational Age Births Could Increase Diabetes Risk in Women – HCP Live

M-A | Low-dose insulin infusion is safe and effective in treating diabetic ketoacidosis in children

23 Feb, 2023 | 13:40h | UTC

Summary: The article discusses a systematic review and meta-analysis of randomized controlled trials comparing low-dose insulin at 0.05 units/kg/hr to standard dose at 0.1 units/kg/hr for children with diabetic ketoacidosis (DKA). The study found that low-dose insulin infusion is probably as efficacious and safer than standard-dose insulin in treating DKA in children, as it has no effect on the time to resolution of hyperglycemia or acidosis and probably reduces the risk of developing hypokalemia and hypoglycemia. However, the results are limited by imprecision and generalizability to other settings since all studies were performed in a single country. Therefore, further studies are required to identify the optimal insulin dose for children with DKA in terms of safety and effectiveness.

Article: Insulin Infusion Dosing in Pediatric Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials – Critical Care Explorations