Tag Archives: diabetes

Introduction Diabetes mellitus is a major global health burden, with type 2 diabetes representing approximately 90% of cases. It is estimated that there were 451 million people with diabetes worldwide in 2017, and there will be 690 million by 2045.1–3 Unfortunately, almost half (49.7%) of the patients with diabetes remain undiagnosed. Diabetes accounts for 10% of global all-cause mortality and is a major risk factor for numerous cardiovascular diseases, including coronary artery disease, hypertension, peripheral vascular disease and heart failure.1 The link between diabetes and cardiovascular disease appears to be at both macrovascular and

What’s new in transplantation Are kidney donors worse off? The meeting was opened by Dr Anna Price (Queen Elizabeth University Hospital, Birmingham) who addressed the long-term cardiovascular effects of unilateral nephrectomy in living kidney donors.1 Previous studies have shown a significant prevalence of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD),2,3 but the effects of reduced renal function in living kidney donors has been unexplored until now. A recent study by Price et al. demonstrated that living kidney donors had a reduction in estimated glomerular filtration rate (eGFR) from 95 to 67 ml/min

Introduction There is an increasing prevalence of atrial fibrillation (AF) worldwide, with a one-in-three lifetime risk of developing AF over the age of 40 years.1 AF is a leading cause of stroke, and stroke risk is increased further in the presence of diabetes.2 Diabetes has been recognised as a risk factor for AF and, therefore, targeted screening for AF in such groups has been explored in combination with comorbid risk factors.2 There are yet to be universally accepted recommendations for AF screening. The European Society of Cardiology (ESC) recommend opportunistic screening in people >65 years and consideration of systematic screening

Introduction Prevalence of atrial fibrillation (AF) and diabetes is increasing worldwide.1,2 AF is a common heart rhythm irregularity and prevalence increases with age. People with AF are up to seven times more likely to have a stroke than the general population,1 with risk increased further in the presence of diabetes.3 AF may exhibit no symptoms and go undiagnosed until patients present with sequelae, such as stroke or heart failure. Stroke secondary to AF is often avoidable with thromboprophylaxis and early identification could lead to stroke prevention. Diabetes mellitus is a major risk factor for cardiovascular disease,4 and frequency of

Introduction It is important to consider quality of life (QoL) when managing the health and wellbeing of patients as it assists in the interpretation of symptoms, functional status, perceptions, experiences and patient expectations.1 Atrial fibrillation (AF) and diabetes are both long-term conditions that are increasing in prevalence. Both AF and diabetes can influence physical and psychological health and reduce QoL.1 Evidence has shown that in up to 40% of patients with diabetes, AF can co-exist,2 and little is known about how diabetes can further worsen QoL in AF. This comparison study, therefore, explores the QoL in these often co-existin

An international faculty of eminent representatives from primary and specialist care have developed a consensus document on the management of diabetes for people at risk of, or with confirmed COVID-19, for use in both primary and secondary care. Published in The Lancet Diabetes and Endocrinology,1 the brief practical recommendations are based on queries seen to be important by clinicians, questions that have been raised by colleagues and social media, and recommendations guided by using focused-literature review. Clinical decision making in the management of diabetes is already complex and in normal circumstances clinicians follow standard gu

It also provides simple pathways for the management of inpatients with diabetes by admitting teams in secondary care; as clinicians and trainees without diabetes expertise are delivering diabetes care during the COVID-19 pandemic. To date the group, comprising UK‐based specialists in diabetes, pharmacy and psychology, have produced two sets of guidelines, which will be continually revised as new evidence emerges. It is supported by Diabetes UK, the Association of British Clinical Diabetologists, and NHS England. Care home guidance A Diabetes UK position statement for the management of diabetes in care homes during the pandemic has also been

Dr Amar Puttanna writes on diabetes and COVID-19 One of the first papers by Wu et al.1 looked at case fatality rates and noted that those with diabetes had a higher rate of 7.3% compared to the overall rate of 2.3%. Further reviews of Chinese patient data from both intensive care and non-intensive care, looking at metabolic disease, noted a diabetes prevalence of 9.7% of patients.2 The authors also noted a two-fold increase in those with diabetes in patients with severe disease (i.e. admitted to intensive care units). Similarly, data from Italy noted that 31.3% of deceased patients with COVID-19 had diabetes.3 It is difficult to conclude anyt

Professor D John Betteridge Professor John Betteridge With sadness, we report the death of Professor D John Betteridge, BSc, MB BS, PhD, MD, FRCP, FAHA, Consultant Physician, University College London Hospitals, London; Emeritus Professor of Endocrinology and Metabolism University College London; and Associate Dean, Royal Society of Medicine (RSM), who passed away on 4th October 2019, aged 71, following a long illness. John will be remembered with great fondness by his many colleagues and friends. He had a long and distinguished career – he was a BJC editorial board member, a past chair of HEART UK and past President of the Council on Lipid

The American Diabetes Association Scientific Sessions 2019 were held in San Francisco REWIND One of the highlights of the conference and, for many, the main event was the presentation of results from REWIND (Researching CV Events with a Weekly Incretin in Diabetes), a cardiovascular outcome trial (CVOT) for the GLP-1 receptor agonist (GLP-1RA) dulaglutide.1 Prior to this trial, the majority of CVOTs (and all prior CVOTs with GLP-1 RAs) were conducted in a predominantly secondary prevention population. Thus any positive cardiovascular (CV) outcomes were only shown in those with established atherosclerotic cardiovascular disease (ASCVD). The ba