Diabetes
Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050
26 Jun, 2023 | 01:00h | UTCSummary: This systematic review analyzed the global burden of diabetes, including trends, projections, and attributions to risk factors. It considered data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), covering 204 countries and territories.
In 2021, an estimated 529 million people worldwide were living with diabetes. Regionally, the highest rates were observed in North Africa, the Middle East, and Oceania. Type 2 diabetes accounted for 96% of diabetes cases and 95.4% of diabetes DALYs (disability-adjusted life-years). More than half of global type 2 diabetes DALYs were attributable to high body mass index (BMI).
Predictions suggest that more than 1.31 billion people will have diabetes by 2050, with high prevalence rates in North Africa, the Middle East, and Latin America. The study notes the ongoing challenge of preventing and controlling type 2 diabetes, largely driven by increasing obesity. An understanding of disparities in risk profiles and disease burdens can inform strategies to control diabetes risk factors.
Editorial: Diabetes: a defining disease of the 21st century – The Lancet
News Release: Global diabetes cases to soar from 529 million to 1.3 billion by 2050 – Institute for Health Metrics and Evaluation
Commentary on Twitter (thread – click for more)
Today: More than 529 million people across the globe have diabetes
In the next 30 years: 1.3 billion people are projected to have diabetes
https://t.co/gh2O0K7RY0— Institute for Health Metrics and Evaluation (IHME) (@IHME_UW) June 22, 2023
Phase 2 RCT | Oral GLP-1 agonist Orforglipron outperforms dulaglutide and placebo in type 2 diabetes control
26 Jun, 2023 | 00:54h | UTCSummary: In a 26-week, phase 2, double-blind, randomized trial spanning multiple centers in the USA, Hungary, Poland, and Slovakia, researchers examined the efficacy and safety of orforglipron, a non-peptide GLP-1 receptor agonist. The sample comprised 383 adults aged 18 and older with type 2 diabetes treated with diet and exercise, with or without metformin, and with a glycated hemoglobin (HbA1c) of 7.0–10.5%.
The study’s primary efficacy outcome revealed that orforglipron achieved a significantly higher mean reduction in HbA1c compared to both the placebo and dulaglutide (-2.10% vs -0.43% and -1.10%, respectively). Furthermore, orforglipron induced a change in mean body weight at week 26 of -10.1 kg, outperforming both the placebo and dulaglutide. Adverse events mostly encompassed mild to moderate gastrointestinal issues.
The study concluded that orforglipron at doses of 12 mg or higher could potentially serve as an effective alternative to injectable GLP-1 receptor agonists and oral semaglutide, for type 2 diabetes treatment. While the drug’s safety profile was consistent with other GLP-1 receptor agonists, there is a need for larger confirmatory studies and dose regimen optimization.
Article: Efficacy and safety of oral orforglipron in patients with type 2 diabetes: a multicentre, randomised, dose-response, phase 2 study – The Lancet (link to abstract – $ for full-text)
Commentary: Orforglipron Shows Promise as Weight Loss, Diabetes Agent in Phase 2 Trials – HCP Live
Phase 2 RCT | Comparative study on CagriSema, Semaglutide, and Cagrilintide in type 2 diabetes
26 Jun, 2023 | 00:52h | UTCSummary: The study, a 32-week multicentre, randomized, double-blind, phase 2 trial, evaluated the combined effect of cagrilintide and semaglutide (CagriSema) on individuals with type 2 diabetes. 92 adults with type 2 diabetes and a BMI of 27 kg/m2 or higher were randomly assigned to one of three treatment groups: CagriSema, semaglutide, or cagrilintide.
The results indicated that the mean reduction in HbA1c was more pronounced with CagriSema than cagrilintide, but not semaglutide. The CagriSema group also showed greater weight loss versus both semaglutide and cagrilintide. In terms of safety, the most common adverse events were mild to moderate gastrointestinal events, with no fatal adverse events reported.
These findings suggest that CagriSema presents as a viable treatment option for type 2 diabetes, offering significant benefits in terms of weight loss and glycemic control. A potential limitation is the short duration of the study, which may not account for long-term effects and safety of the intervention. The authors conclude that these results support further investigation of CagriSema in larger, longer phase 3 trials.
Article: Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial – The Lancet (link to abstract – $ for full-text)
Review | Evaluation and management of diabetes-related foot infections
23 Jun, 2023 | 13:36h | UTCEvaluation and Management of Diabetes-related Foot Infections – Clinical Infectious Diseases
Related: Guideline Series | Prevention and management of diabetes-related foot disease
Cohort Study | Real-world data links valproate, antipsychotics to higher diabetes risk in bipolar disorder
23 Jun, 2023 | 13:32h | UTC
SCORE2-Diabetes | 10-year cardiovascular risk estimation in type 2 diabetes in Europe
22 Jun, 2023 | 14:57h | UTC
Commentary on Twitter
SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe https://t.co/lkPTzqk0Kg @escardio #EHJ #ESCYoung pic.twitter.com/5TxesSwN1t
— European Society of Cardiology Journals (@ESC_Journals) June 14, 2023
The foot in diabetes – a reminder of an ever-present risk
21 Jun, 2023 | 13:10h | UTCThe foot in diabetes – a reminder of an ever-present risk – Clinical Medicine Journal
Related: Guideline Series | Prevention and management of diabetes-related foot disease
RCT | No significant kidney outcome differences observed across glucose-lowering medications in T2D patients
15 Jun, 2023 | 15:02h | UTCComparative Effects of Glucose-Lowering Medications on Kidney Outcomes in Type 2 Diabetes: The GRADE Randomized Clinical Trial – JAMA Internal Medicine (link to abstract – $ for full-text)
See also: Visual Abstract
Commentaries:
No differences found in effects of secondary diabetes drugs on kidney outcomes – ACP Diabetes
Do glucose-lowering medications have different effects on kidney outcomes? – News Medical
SR | Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes
15 Jun, 2023 | 14:57h | UTC
M-A | Elevated HbA1c in gestational diabetes mellitus tied to 1.7-fold rise in large for gestational age incidence
13 Jun, 2023 | 13:39h | UTC
Guideline Series | Prevention and management of diabetes-related foot disease
7 Jun, 2023 | 13:41h | UTCDefinitions and criteria for diabetes-related foot disease (IWGDF 2023 update)
Guidelines on the classification of foot ulcers in people with diabetes (IWGDF 2023 update)
Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update)
RCT | Tirzepatide outperforms insulin glargine in HbA1c reduction and weight loss in type 2 diabetes
6 Jun, 2023 | 14:39h | UTC
Commentary on Twitter
The SURPASS-AP-Combo trial shows that addition of #tirzepatide as 2L or 3L therapy is non-inferior & superior to insulin glargine for glycemic outcomes at 40 weeks in an Asia-Pacific (mostly Chinese) population w/ type 2 #diabetes. https://t.co/RDh2WSJ1wZ pic.twitter.com/nm6pPpVdxH
— Nature Medicine (@NatureMedicine) June 2, 2023
Podcast | Insulin, type 2 diabetes, and hypoglycemia
6 Jun, 2023 | 14:25h | UTC#397: Insulin, Type 2 Diabetes, Fanny Packs, and Hypoglycemia with Dr. Jeff Colburn – The Curbsiders
Phase 2b RCT | Danuglipron, an oral GLP-1R agonist, reduces body weight and improves glycemic control in type 2 diabetes
1 Jun, 2023 | 12:17h | UTC
Review | Exercise training and revascularization in the management of symptomatic peripheral artery disease
25 May, 2023 | 11:23h | UTC
Commentary on Twitter
Exercise Therapy and Revascularization in the Management of Symptomatic Peripheral Artery Diseasehttps://t.co/Nywh4YxIs3 pic.twitter.com/K8z7E5eK9v
— Physio Meets Science (@PhysioMeScience) May 7, 2023
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes
24 May, 2023 | 13:30h | UTC
Review | Glycemic management in people with diabetes on peritoneal dialysis
24 May, 2023 | 13:04h | UTC
Commentary on Twitter (thread – click for more)
1/Hey #Nephtwitter #Medtwitter
Today, we are discussing
Clinical considerations while managing diabetes on Peritoneal dialysis (PD)#Tweetorial alert ?@KIReports
Full text link: https://t.co/sOEIa6AuNh pic.twitter.com/kVn4XDYylU— KIReports (@KIReports) May 20, 2023
AHA Statement | Addressing diabetes and atherosclerosis in Asian American adults: insights, management, future steps
22 May, 2023 | 13:42h | UTCNews Release: Culture, diet, economic factors and more affect CVD risk among Asian Americans – American Heart Association
Commentary: Think Differently: Diabetes, CVD Risks in Asian Americans Not Uniform, AHA Says – TCTMD
Commentary on Twitter
Examining Asian American subgroups separately is crucial to understanding different mechanisms that contribute to T2D & ASCVD risks. The new scientific statement: https://t.co/taTVvXtXd2 @CircAHA @kwancardio @SallySWong @alka_kanaya @HeartDocSadiya @SvatiShah @FFR81 @hayman_ll pic.twitter.com/lWtl1AKBKg
— AHA Science (@AHAScience) May 8, 2023
RCT | Once-weekly insulin icodec shows non-inferiority to daily insulin glargine in type 2 diabetes patients
18 May, 2023 | 13:48h | UTCSwitching to once-weekly insulin icodec versus once-daily insulin glargine U100 in individuals with basal-bolus insulin-treated type 2 diabetes (ONWARDS 4): a phase 3a, randomised, open-label, multicentre, treat-to-target, non-inferiority trial – The Lancet (link to abstract – $ for full-text)
M-A | Adding exercise to hypocaloric diet doesn’t enhance weight loss or glycemic control in T2D patients
15 May, 2023 | 12:52h | UTC
Review | Perioperative glycemic management in adults presenting for elective cardiac and non-cardiac surgery
11 May, 2023 | 11:54h | UTCRelated:
Guideline Summary: New guidance on the perioperative management of diabetes.
Perioperative Evaluation and Management of Endocrine Disorders – Mayo Clinic Proceedings
Guideline | Use of basal insulin in the management of adults with type 2 diabetes
10 May, 2023 | 15:30h | UTCRelated: Guideline | ADA 2023 Standards of Medical Care in Diabetes.
Consensus Statement | Comprehensive type 2 diabetes management algorithm – 2023 update
9 May, 2023 | 15:10h | UTCRelated: Guideline | ADA 2023 Standards of Medical Care in Diabetes
RCT | Early treatment of gestational diabetes slightly lowers risk of adverse neonatal outcomes
9 May, 2023 | 14:55h | UTCTreatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Early treatment of gestational diabetes for those at higher risk beneficial, study finds – Western Sidney University
Metformin: update on mechanisms of action and repurposing potential
8 May, 2023 | 13:05h | UTCMetformin: update on mechanisms of action and repurposing potential – Nature Reviews Endocrinology (if the link is paywalled, try this one in PMC)
Commentary on Twitter
New content online: Metformin: update on mechanisms of action and repurposing potential https://t.co/30uhafcKPu pic.twitter.com/kfyzDEUlBg
— Nature Reviews Endocrinology (@NatureRevEndo) May 2, 2023