Tag Archives: diabetes

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

Stat tests loaded into the VITROS XT 7600 Moderate alcohol consumption does not protect against stroke Blood pressure and stroke risk increase steadily with increasing alcohol intake, and previous claims that one to two alcoholic drinks a day might protect against stroke are not borne out by new evidence from a genetic study involving 160,000 adults. Studies of East Asian genes, where two common genetic variants strongly affect what people choose to drink, show that alcohol itself directly increases blood pressure and the chances of having a stroke, according to a new study published in The Lancet (doi: 10.1016/S0140-6736(18)31772-0). Researc

Relationship between diabetes and AF Mass screening of AF in the STROKESTOP study2 discovered diabetes, heart failure and previous stroke/transient ischaemic attack (TIA) to be the strongest predictors for AF in multi-variate analysis. This confirms findings from the historical Framingham study, where diabetes conferred a 1.4-fold increased risk of stroke in men and a 1.6-fold increased risk in women.3 A recent review of the evidence from AF screening studies in those with perceived high risks, has demonstrated the prevalence of AF in people with diabetes ranges from 2.9%4 to 18.5%.2 Chan and Choy’s study (2016)5 did not find diabetes to be

The risk of developing type 2 diabetes is amplified among the South Asian population in the UK, with estimates suggesting a two- to fourfold increase in risk. Why is this? Hanif and Susarala review putative reasons why South Asian people represent at least 15% of the population of people with diabetes in this country, and who also carry higher microvascular complication rates than their European counterparts. Although the reasons for excess coronary heart disease (CHD) mortality risk in South Asians are not entirely clear, studies have found higher levels of conventional risk factors present at a younger age, which may be an explanation for