Guest guest Posted July 29, 2012 Report Share Posted July 29, 2012 1.%% M 6/27 FDA Approves Belviq -First New Weight-Loss Drug in More Than a Decade Belviq (lorcaserin), was approved for obese adults who have high BP, high cholesterol or T2. D Katz, Yale said " .. its effects appear to be modest & there are still concerns about a potential for damage to heart valves.. " The drug works to help suppress appetite by activating an area of the brain called the serotonin 2C receptor. The weight-loss drugs fenfluramine & dexfen-fluramine " fen-phen, " targeted a different part of the serotonin system, & were pulled from the market because they boosted the risk of heart valve damage. [8,000 pts;1yr] Treatment also included diet & EX. Among the pts with T2, 38% lost at least 5% of their weight vs 16% of those on the dummy pill. " People need to understand that lifestyle modifications are essential for successful weight loss, wt maintenance, & fitness programs. Belviq should be stopped if pts don't lose at least 5% of their weight within 12 wks, since they're unlikely to benefit from taking the drug for any longer period of time. 2.%% ADA 6/29 Genetics of Diabetes DM does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to get diabetes than others. T1 & T2 have different causes. Yet 2 factors are important in both -- You inherit a predisposition to the disease then something in your environment triggers it. Genes alone are not enough. When one Identical twin has T1, the other gets the disease.. only half the time. When one twin has T2, the other's risk is at most 3 in 4. In most cases of T1, people need to inherit risk factors from both parents.. T1 is more common in cold climates. Another trigger might be viruses. Perhaps a virus that has only mild effects on most people triggers T1 in others. T1 is less common in people who were breastfed.. In studies of relatives of people with T1, most of those who later got DM had certain autoantibodies in their blood for years before. (Antibodies are proteins that destroy bacteria or viruses). Auto-antibodies are anti-bodies 'gone bad,' which attack the body's own tissues.) T2DM has a stronger link to family history & lineage than T1 although it too depends on environmental factors & lifestyle. It may be difficult to figure out whether your DM is due to lifestyle factors or genetic susceptibility. Most likely it is due to both. 3.%% ADA 6/28 Anxiety disorder & other psychiatric conditions may be more likely with diabetics Many are aware that DM is a physical health challenge, but it turns out that diabetics may also be more likely to struggle with psychiatric problems. [200pts] neuropsychiatric assessments-21% were classified as having general anxiety disorder, 24% some type of depression,2.5% had panic disorder & 2% were considered at " risk of suicide " . How could a blood sugar disorder affect mental health?.. Human physiology is a balancing act, where energy must be acquired then used or stored. " Diabetes " is a label for disorders where energy-rich sugars are not metabolized correctly, resulting in unhealthy high blood glucose levels. The hormone insulin, secreted from the pancreas causes certain cells to take in & store BS. Some times not enough insulin is produced to regulate BS or cells do not properly respond to the insulin signals These situations correspond to the 2 major categories of DM: T1- pancreas does not make enough insulin;T2 cells do not process blood insulin correctly. Study results point to the need for increased appropriate evaluation of pts that considers mental issues. " Comp Psych 4/2012 4.%% ADA 6/29 Apolipoproteins (apos) Are Biomarkers for Diabetic Retinopathy -Sasongko & team investigated whether apoAI & apoB levels correlated with measures of systemic & retinal microvascular function in 224pts " Our findings may elucidate the role of apos in DR & support previous evidence that serum apos are stronger bio-markers for DM retinopathy, & possibly other diabetic microvascular complications, than traditional lipids, " 5.%% M 7/2 Study Supports Intervention in NSTEMI Diabetics A meta- analysis of nearly 10,000 pts supports early intervention rather than a conservative approach for non-ST-elevation myocardial infarction (NSTEMI) [type of heart attack] in diabetics. Invasive strategies reduced nonfatal MI in DM patients Relative Risk 0.71, but not in non-DM pts RR 0.98 vs conservative strategies.The absolute risk reduction in MI with an invasive strategy was greater in diabetics than in nondiabetics 3.7% vs 0.1%) there were no differences in death or stroke between the groups J AmerCollege Cardiology 7/10/12 6.%% ENDO 2012 Modified Sleeve Gastrectomy Can Treat T2 Dr. K Modi, presenter advises physicians to consider the surgery at an earlier stage of T2DM not as a last resort. [43pts] had sleeve gastrec-tomy & an ileal interposition; [17pts who had DM for +15yrs, had diverted sleeve gastrectomy + ileal interposition.] The procedure diverts food from the duodenum. In a 20m f-up there was remission in 20 pts of the first group & 2 of the 2nd grp. When Dr.M excluded data from pts who were not obese, the remission rate rose from 47% to 85%. The surgery's effects may be two-fold. The sleeve restricts calories absorbed & reduces ghrelin ( " hunger hormone " ), ileal inter-position causes foods to stimulate the ileum - increasing GLP-1 secretion. 7.%% M Safety and Efficacy of Exenatide Once Weekly for Treatment of T2DM Results from 6 randomized, comparator-controlled studies in over 3000 pts indicate that Rx with exenatide once weekly results in significant glycemic improvements & weight loss. Gastrointestinal adverse effects ..are common, but rarely lead to drug discontinuation. Conclusions: Exenatide once weekly holds promise as a convenient, efficacious, & well-tolerated antihyperglycemic agent for T2. Studies evaluating outcomes such as CV events or all-cause mortality with exenatide once weekly are lacking. 8.%%MA Body adiposity index, body fat content & incidence of T2DM Diabetologia. 2012; 55(6): aim of this study was to compare estimates of body fat content, i.e. body adiposity index (BAI), BMI & waist & hip circumferences, with respect to their ability to predict the percentage of body fat (PBF; confirmed by MRI) & incidence of T2. [ 3 studies= 36,527pts] Results: BMI more strongly correlated with PBF than BAI while waist circumference among men & hip circum among women showed the strongest correlations. BAI was not as strong a predictor of DM as BMI, while waist circum was the strongest predictor. 9.%% M 7/2 Experimental T1DM Drug DiaPep277Continues to Show Promise Andromeda Biotech's new drug which is given by injection, improved the ability of the pancreas to secrete insulin in a phase 3 trial. Pts given DiaPep277 for at least 1 yr maintained the ability to secrete insulin significantly better than the group on placebo - with a relative treatment effect of 23.4%. The treated grp also had fewer hypo events & required less insulin. [457pts;2yrs] the drug acts by modulating the immune system, preventing destruction of pancreatic cells that secrete insulin..Reuters Health Information © 2012 10.%% Vision Aware 6/28 Are Memory Problems Linked to Eye Disease & Diabetes? by Maureen Duffy Two recent studies suggest that memory loss & cognitive decline may be linked to (a)DM, ( poor control of BS by pts with DM, and/or © damage to retinal blood vessels, called retinopathy. Retinopathy is a general term that describes damage to the retina, the thin, light- sensitive tissue that lines the inside surface of the eye. Nerve cells in the retina convert incoming light into electrical impulses, which are carried by the optic nerve to the brain. Retinopathy occurs when there is damage to the small blood vessels that nourish tissue & nerve cells in the retina. Retinopathy is a frequent complication of DM & uncontrolled high BSs. This is a leading cause of blindness & low vision among adults in the US. DM & high BP have also been linked to declines in memory & thinking abilities. A study linking cognitive function & retinal & ischemic brain changes was seen in the Women's Health Initiative published in the 3/27/12 issue of Neurology. This study examined the assoc between retinopathy & cognitive decline in older women. Ischemic refers to a decrease in the blood supply to a bodily organ or tissue, caused by blood vessel constriction or obstruction. The study suggests that damage to retinal blood vessels could indicate the presence of similar damage to blood vessels in the brain, causing problems with cognition, memory & thinking. [511 women;65 plus;10yrs] they had annual tests of mental function, an eye exam 4yrs after entering the study & brain scans 8 yrs after enrolling. Compared to women who did not show evidence of vessel damage to the eyes, these women had lower average scores on the memory & thinking tests. Brain scanning revealed that they also had more evidence of blood vessel damage within the brain. The findings suggest that even very early retinopathy may be an indicator for small vessel disease & a risk factor for blood vessel-related memory & thinking declines. A second study on DM, glucose control & cognitive decline was pub in the 6/18/12 issue of Archive of Neurology-a 10yr study that looked at whether having DM increased the risk of cognitive decline among elderly persons & if poor BS control was related to impaired cognitive performance. [6,069pts] The team found that DM & poor glucose control are assoc with worse cognitive function which suggests that severity of DM may contribute to accelerated cognitive aging. Results supports the hypothesis that older adults with DM have reduced cognitive function & that poor glycemic control may contri-bute to this association. Future studies should determine if early diagnosis & Rx of DM lessen the risk of developing cognitive impairment. Ca 11.%%M 7/6 Sharp Rise in Adult Eye Diseases as Baby Boomers Age Based on the US Census of 2010, the number of people age 50 plus r with late AMD has increased 25%, the number age 40 plus with open- angle glaucoma has increased 22%. However there was a 89% increase in diabetic retinopathy in pts 40 yrs plus from the prevalence in 2000. " It's no surprise that the numbers of those affected by eye disease are continuing to climb, especially due to the aging Baby Boomer population, " D Friedman, Wilmer Eye Institute said, This study provides " a call for a need for kind of rethinking how we deliver care and how we provide better care more efficiently, J Salz, MD, an ophth. said that frequent exams to detect these conditions early are more important than ever because early treatment can lead to better vision outcomes. " This has always been true of glaucoma, but is now important for macular degeneration & diabetic retinopathy because new treatments (anti-VEGF [vascular endothelial growth factor] injections, for example) can result in better outcomes. " 12.%% MPD 7/9 Pump, Real-Time Monitor Best in Type 1 For T1DM, sensor-augmented pump therapy [sPT] gives better control of blood glucose than the traditional method of finger- sticks & insulin injections, SH Golden & team found in a review of 33 randomized, controlled trials. Pts on SPT, which involves real-time continuous glucose monitoring (CGM) & continuous insulin infusion, lowered their HbA1c far more than those doing standard monitoring & injec-tions- in T1 by 0.68% Remove the CGM & there was little difference between the insulin pump & multiple shots of insulin each day. The study found that the traditional method of multiple daily injections & the newer continuous insulin infusion pumps were similar in terms of their effects on HbA1c for adult & pediatric T1 or T2 pts. without any difference in severe hypo. This study noted, however, that there was little evidence available for assessing other outcomes, including severe hypo or quality of life, between SPT & the most traditional method. Children with T1 were more satisfied with their Rx if they were on the pump. This data suggests the approach to intensive insulin Rx can be individualized to pt preference that will maximize their therapy satisfaction.. Future research should include larger studies among subpopulations..such as the elderly, minorities, & those who use insulin to treat T2. Yeh HC, " Comparative effectiveness & safety of insulin delivery & glucose.. Ann Intern Med 2012. Ca 13.%% M 7/9 Effects of Some Anti-diabetic & Cardioprotective Agents on Human Coronary Artery Cells The leading cause of death for pts s suffering from DM is macrovascular disease. Endothelial [inner lining of blood vessels] dysfunction is often seen in T2pts & it is considered to be an important early event in atherogenesis [forming plaques in arteries] & cardiovascular disease. Endothelium protects the vessels from clotting & inflammatory factors. It also participates in the regulation of blood flow & BP. Conclusion - Our results suggest that the anti-diabetic & cardioprotective agents mentioned above [includes - insulin & metformin] have direct & beneficial effects on endothelial cell viability & regeneration. This may increase their clinical utility in T2 pts with endothelial dysfunction that adversely affects their survival. CV Diabetol. 2012;11(27) 14.%% M 7/3 New Position Statement on Diabetes Mellitus in Older People " The effective management of the older patient with DM requires an emphasis on safety, DM prevention, early Rx for vascular disease, & functional assessment of disability due to limb problems, eye disease, & stroke. In addition in older age, prevention & manage-ment of other DM-related complications & assoc conditions, such as cognitive dysfunction, & depression, become a priority, " authors say. Glucose Targets, individual comorbid conditions, as well as cognitive & functional status, should be considered in deter-mining glucose goals, but in general they recommend a HbA1c target range of 7-7.5%. Low glucose states (glucose levels < 5.0 mmol/L) should be strictly avoided. BP threshold for Rx of hypertension is 140/80mm Hg (150/90 for pts age 75 +) All pts should have an individ physical activity program that includes resistance training, balance EX, & CV fitness training. supported by the Internat Assoc of Geriatrics & Gerontology & European DM Working Party for Older People. JAMDA. 2012;13: 15.%% M 7/10 Diabetes & Frailty: An Emerging Issue - .. DM is a premature ageing syndrome & shares some of the key characteristics of frailty..which is a state of increased vulnerability to stressors that results from decreased physiological reserve .. Sarcopaenia is the loss of muscle mass assoc with aging. The maintenance of skeletal muscle mass is influenced by multiple factors including hormonal, inflammatory, neurological, nutritional & limb activity.. Sarcopaenia by way of its profound effects on lower limb function is a potentially important contributor to the disabling condition associated with DM & may be a precursor to frailty..Part 1: Sarcopaenia & Factors Affecting Lower Limb Function British J of Diab & Vascular Disease. 2012;12(3): 16.%% ARVO 2012 7/11 Retinal Disease: Advances in Treatment R Steinert, MD; B Kuppermann, MD, PhD UC Irvine Ophthalmology Our task today is to discuss (ARVO) meeting, particularly with reference to the topics on retina. Dr. S I would like to gear this toward non-retina specialists, which is still most of us..CATT is a landmark (NIH)-funded trial that compares bevacizumab [avastin] with ranibizumab [lucentis] for treatment of wet macular degeneration. Bev.. is the monoclonal antibody of vascular endothelial growth factor (VEGF) approved by (FDA) for systemic use in certain cancers, whereas rani.. is the antigen-binding fragment of that antibody developed specifically for the eye. Bev.was discovered, to be useful in small doses intravitreally [injected into the jelly part of the eye] to treat wet macular degeneration with choroidal neovascularization. [growth of new abnormal blood vessels] The retina community used intravitreal bev. for about a year before rani.. was approved by FDA; this is going back 5-7 yrs. Since that time, both drugs have been used extensively for wet AMD, with seemingly similar benefits to patients. A question arose, however, as to how similar these 2 compounds were in treating wet AMD -- This led to the CATT study in an attempt to compare the safety & efficacy of these 2 drugs.. also to determine whether aggressive, as-needed injections provided similar efficacy as fixed regimen injections every 4 wks. It was a noninferiority study, which is a little bit complicated statistically, & it had 4 arms based on drug & dosing schedule. What we saw last year was that bev Q4 wks was noninferior to ranibizumab Q4wks.Rani PRN was also noninferior to [both drugs] every 4 wks. Basically, the results of year 1 were corroborated at year Anti-VEGF Therapy for Diabetic Macular Edema - Our off-label use of bev for DM mac edema didn't seem to be quite as effective during the first clinical trial..In that DRCR.net protocol, I saw that ranibizumab, on a monthly basis, had dramatically better results than laser -- and, in fact, better results than steroids injected every 4 months... The Human and Nonhuman Genome - J. Craig Venter, one of the preeminent authorities in genetics & genomics has been looking at the impact of the nonhuman genome on humans in our close environ-ment. Apparently animals, including humans, are releasing epithelial cells all the time, which are lifted into the air that we then breathe in. He sampled air in midtown Manhattan 20 stories up, & found that more than 50% of the air contained rodent DNA...there is now a large effort on looking at all the things in the human body that are nonhuman ..It turns out that something like only 10% of the genes in the human body are human. The rest are bacterial, from our gut & various organs. it could be that the bacterial genes in our body are altering the environment & therefore modifying our own genetic expression. But it's interesting how the bacteria in our body play such a vital role in our health. It's very much a symbiotic relationship.There are pathogens that are our enemies, but the overwhelming majority of the bacteria in our body are our friends. There is a huge effort under way called Metagenomics of the Human Intestinal Tract (MetaHIT),to perform genetic analysis of all these additional genes in the human body that are not human genes. Medscape Oph © 2012 WebMD, LLC 17.%% M 7/16 Resting-state Brain Networks in T1 Patients With & Without Microangiopathy (MA).. Cognitive functioning depends on intact brain networks that can be assessed with functional magnetic resonance imaging (fMRI). [101pts;48 controls] MA+ pts showed decreased connectivity in networks involving [includes] attention, memory, auditory & language processing... Better information- processing speed & general cognitive ability were related to increased connectivity. T1DM is associated with a functional reorganization of neural networks that varies, dependent on the presence or absence of microangiopathy [disease of capillaries, leaking, etc] All pts had a detailed neuropsychological assessment. MA+ pts were significantly older & reported the highest number of depressive symptoms compared with both other groups. Compared with MA-pts, MA+ patients had an earlier onset age & longer disease duration, & a higher rate of hypertension. Diabetes.2012;61(7) 18.%% Hormone Discovered That Preserves Insulin Production & Beta Cell Function in Diabetes Duke U researchers have found protective, anti-DM functions for a hormone that, like insulin, is produced by the islet cells of the pancreas. TLQP-21 was found to stimulate insulin secretions from rat & human islet cells & protect islet cells. This discovery could open to further research toward prevention & treatments for T1DM & T2DM. The team gave TLQP-21 to diabetic fatty rats, which have a genetic propensity to develop T2. There was significant improvement in insulin & glucose levels & less beta cell deaths in the treated animals. Finding a way to produce more of this protective hormone could be valuable in the Rx of DM. ..the team plans to test the hormone in T1 in future studies. TLQP-21 is similar to another naturally occurring hormone produced in the digestive tract, a glucagon-like peptide-1(GLP-1). What's exciting is that in the animal studies of TLQP-21, no consequential side effects were seen. The study rats ate normal amounts of food, & didn't show any changes in heart rate or digestion patterns when they were given large doses of the hormone. The next step is to find a small molecule that could stimulate the islet cells to produce more of the TLQP-21 hormone, or to develop more potent versions of the injected hormone. www.dukehealth.org/health_library/news/ 19.%% ASMBS 7/16 Abandon Gastric Banding Bariatric Surgery, Say Experts L Angrisani, Italy presented 10-yr fup data from a randomized trial [51pts] comparing laparoscopic Roux-en-Y gastric bypass with banding " There is no point in doing further study comparing bypass with banding..If you consider revisions & failures, only 26% of the banding pts had..a successful weight loss, " Of the 24 bypass pts in his study 1 had T2. Europeans ..started banding procedures before North Amer, & therefore detecting problems earlier, said Dr. A. " This is a very common story. While Europeans accept the messages from the US world of surgery, the US community does not accept data coming from Europe. " The European experience is more mature than the US experience with gastric banding, " agreed J Morton, Stanford " although 6-yr data for sleeve gastrectomy indicate that it is safe & effective, the potential long-term complications for the sleeve may not be fully apparent yet, & ..banding may still be preferred due to it's favorable short-term safety profile. " [see #6 for sleeve effect on T2] 20.%% ADA 7/16 Effects of Roux-en-Y Gastric Bypass Surgery in Pts with T2 & Only Mild Obesity RYGB ameliorates T2 in severely obese pts through mechanisms beyond just weight loss .. We studied the long-term impact of RYGB on pts with DM & class I obesity [66 pts BMI 30–35kg/m;fup 6yr] Weight loss failed to correlate with several measures of improved glucose homeostasis, C-peptide responses to glucose increased substantially, suggesting improved ß-cell function. There was no mortality, major surgical morbidity, or excessive weight loss. Hypertension & dyslipidemia also improved, yielding 50–84% reductions in predicted 10-yr CVD risks of fatal & nonfatal coronary heart disease and stroke. Conclusions: The effect of RYGB on DM is impressive. Approx 80–85% of severely obese patients with T2 who undergo this operation experience full remission of DM.. Routine clinical use of RYGB, however, remains bounded by a 1991 NIH consensus statement, which set limits for the use of bariatric surgery at BMI at 35 kg/m2 ...required to approve surgical obesity Rx. Pts with a BMI between 30-35(class I obesity) are the most numerous group of obese persons. Patients with T1 or undetectable ß-cell function were excluded from this study. DM remission was defined as HbA1c <6.5% without use of any DM meds. Diabetes was considered improved if pts still required oral medication at lower dosages than [before surg] (but no insulin) & had HbA1c <7.0%.: At the latest f-up 88% of pts had remission [measured as above]11% had improved DM, & 1 did not have a clear change in glycemic control. Remission occurred between 3 & 26 weeks after RYGB.. We found no relationship between change in body weight & change in HbA1c or the magnitude of improvement in ß-cell sensitivity to glucose. World Congress InterventionalRx for r T2 & Internat DM Fed thought leaders recommended that RYGB be considered to treat poorly controlled T2 in pts with BMI 30–35 kg/m 2.. Additional data are needed from RCTrials before routinely recom-mending RYGB in pts with BMI <35 [less than]DiabetesCare2012;35(7) 21.%% NatREndo 7/20 Muscles, exercise & obesity: skeletal muscle as a secretory organ Studies in the past few years suggest the existence of yet unidentified factors, made by muscle cells, which may influence cancer cell growth & pancreas function [pancreas is the source of insulin]. Many proteins produced by skeletal muscle need muscle movement to be secreted; this fact could be a potential mechanism for the assoc between sedentary behaviour & many chronic diseases. [ie T2] 22.%% NREndo 7/20 CV risk in double DM- when 2 worlds collide Historically, clinical management of pts with T1 has been focused on BS control, which is sometimes achieved at the expense of weight gain on intensive insulin regimes. Several studies have concluded that factors related to obesity, metab syndrome & insulin resistance [iR] are more important than HbA1c for prediction of CV risk. 'Double DM’ is a combination of T1 & characteristics of T2 including central [obesity] & worsened IR. 23.%% M 7/23 Hepatitis B [HB] Vaccine for Adults With DM T. MD, Centers for Disease Control & Prevention. CDC's Advisory Com on Immunization Practices recently added adults with both T1 & T2 to the list of persons at increased risk for hepatitis B infection & recom-mended that they receive HBvaccination. Study by CDC [800 cases] of acute HB adults with DM younger than 60 had twice the risk for acute hepB infection as those without DM of the same age. Adults with DM over 60 were also at increased risk for HB infection, but the increase was not statistically significant. CDC now recommends HBvac for all unvaccinated diabetics younger than 60. Vaccination should occur as soon as possible after diagnosis of DM should also be given to adults diagnosed with diabetes in the past. Vac. requires 3 doses at 0, 1, & 6 m. Factors that might support vaccinating adults with DM age 60yrs plus include recent diagnosis of DM in older adults with generally good health. HepB is a viral infection of the liver that can cause serious illness in adults–about 40% of adults with HB need hospitalization, 4% die from early complications of the infection. Among adults with chronic HB 15% progress to cirrhosis & liver failure or liver cancer. 24.%% M 7/24 Sexual Function Diminished in Women With Diabetes Middle-aged women with DM reported lower levels of sexual desire, satisfaction, & frequency than their nondiabetic counterparts. Women with insulin-treated diabetes also reported more difficulty with lubrication, unlike women with DM who did not need insulin.[2270 women;40-80yrs] A Rapkin,UCLA whowas not involved in this study, agreed with the authors' that Rx of women with DM should include a sexual history & clinicians should counsel pts that preventing end- organ complications may help preserve their sexual function. Funded Nat Inst DM, Digestive & Kidney Diseases (NIDDK) 25.%% MPD 7/25 FDA Panel to Mull Diabetic Eye Disease Drug Genentech's blockbuster eye drug ranibizumab (Lucentis) helped improve vision for DM pts with macular edema [DME] but the drug's higher of 2 doses comes with more adverse events. Rani.. is already approved to treat wet AMD & macular edema following retinal vein occlusion. The committee will consider whether to support an indication for DME. For the past 30 yrs, it's been treated with laser photocoagulation; however, few pts notice a benefit in vision.Further, laser can destroy retinal tissue & decrease sensitivity to color. The application is based on 2 randomized, double-blind, sham-controlled 3yr studies of 750 pts who had injections of either 0.5 or 0.3mg of the drug or placebo, once a month for 24m/.. Re adverse effects, 11pts in the 0.5-mg group died, as did 7 in the 0.3-mg group, & 3 on placebo. (rates 36.4%,32.4%, & 33.2%, respectively.) Specific adverse events included: Myocardial infarction, Pneumonia, Kidney failure. The number of eye-related adverse events were similar in all Rx groups. The advisory committee will vote Thursday on whether the drug is safe and effective, and if so, which dose should be approved. %% 7/26 Panel Says OK --advisory com voted unanimously on thurs to recommend approval of a new indication for ranibizumab for the treatment of DME. There was unanimity on the lower 0.3 mg dose;the 0.5 mg dose won members' assent with an 8-2 vote. 26.%% M 7/26 Effects of Linagliptin Persist in Treatment Extension Linagliptin safely controls BS in pts with T2 .. [2000pts;102wks] all pts started with inadequately controlled T2DM & received placebo or oral linagliptin 5 mg as daily only , or in addition to metformin, metformin plus a sulfonylurea, or pioglitazone. Author said " With linagliptin monotherapy, the HbA1c change from baseline to wk102 was –0.5%, " The overall incidence of adverse events was 81% of those14.3% were drug-related The most common adverse events were hyper or hypo-glycemia, nasopharyngitis, upper respiratory tract infections, and urinary tract infections. " Linagliptin as monotherapy or in combo. with other oral glucose-lowering agents is a safe & effective option for the long-term treatment of T2, " study sponsored by Boehringer Ingelheim. Int J Clin Pract. 2012;66: 3rd International Congress on Abdominal Obesity (ICAO). American Society for Metabolic and Bariatric Surgery (ASMBS) 29th ENDO 2012: The Endocrine Society 94th Annual Meeting %% Abbreviations-acronyms fup-follow up; pt - patient/participant ; DM - diabetes Mellitus; T1- type 1 DM;T1A -autoimmune T1; T2 - type 2; DME - diabetic macular edema;DR - DM retinopathy; BS/BG- blood sugar/glucose; HA1C, glycated hemoglobin A1C; BP -blood pressure; CVD - cardio-vascular disease; IR- insulin resistance; OCT-optical coherence tomography; BCVA - best corrected visual acuity; RYGB- Roux-en-Y gastric bypass; RCT -Randomized controlled trial; ADA - Am Diab Ass;J- Joslin DMCenter; M- Medscape Web MD; MA- Medline Abstract, MP- Medline Plus; MPD - Med Page Today; NEI - Nat Eye Institute;SciA-Scientific Amer. Definitions via online Medical dictionaries. Disclaimer, I am a BSN RN but not a diabetic or diabetic educator. Assistant Editor: Cam Acker, 50yr DM survivor. Reports excerpted unless otherwise noted. [translations/explanations by thl] This project is done as a courtesy to the blind/visually impaired & diabetic communities. Dawn Wilcox RN BSN Coordinator The Health Library at Vista Center; an affiliate of the Stanford Hospital Health Library. contact above e-mail or thl@... Quote Link to comment Share on other sites More sharing options...
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