Tag Archives: diabetes

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

Introduction Throughout this supplement, there has been discussion of the epidemiology of cardiovascular disease within people with diabetes, and a focus on the management of glycaemia. Given that the majority of people with diabetes ultimately die a premature cardiovascular death, diabetes management has become synonymous with cardiovascular risk reduction. However, since the United Kingdom Prospective Diabetes Study (UKPDS),1 it has become increasingly clear that the multi-factorial nature of diabetes requires a multi-factorial approach. Initially, much of this was extrapolated from existing cardiovascular data, with diabetes just being re

Do new diabetes drugs protect the heart and kidney? The day’s keynote session was given by Professor Johannes Mann (Friedrich Alexander University of Erlangen, Germany). Diabetes management has been transformed with the introduction of newer agents with the promise of cardiovascular and renal protection. The sodium glucose co-transporter-2 (SGLT-2) inhibitors are known to reduce the hyperfiltration, which occurs in early diabetic nephropathy. Glucagon-like peptide 1 (GLP-1) receptor agonists are incretin mimetics, which have several benefits for diabetes management. The mechanisms by which GLP-1 agonist therapy may reduce blood pressur