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The Net Guide: Diabetes

MDNG Primary Care, June 2010, Volume 12, Issue 6

We searched the Internet for diabetes resources so you don't have to.

//The Educated PatientTM

Diabetes and Me

This CDC-developed site features more than 10 tools for patients and their families. In addition to basic facts about diabetes, the site also covers diabetes in specific populations, such as women and some racial and ethnic groups. The sections on physical activity and staying healthy discuss how exercise and keeping up with various diabetes-related tests can give patients better quality of life. Loved ones who are concerned about their risk for diabetes will benefit from the pre-diabetes and prevention sections, designed to help individuals control their risk factors for diabete and avoid lifestyle choices that can contribute to the condition.

Link Code:a12621


Type 1 Diabetes — FamilyDoctor.org

This site discusses the keys to effective blood sugar control, how to recognize when blood sugar is too high and what to do when that is the case, and how to recognize when blood sugar is too low and how to alleviate the symptoms of hypoglycemia. These important facts about blood sugar will provide patients with an easily accessible, basic resource to utilize at any time. Other topics covered here include the symptoms of type 1 diabetes, tips for healthy eating, and how to prevent complications commonly associated with diabetes.

Link Code:a12622


//Medical Websites

DiabetesPro — Professional Resources Online

Check out the toolbars on each side of the Diabetes Pro homepage, which is the American Diabetes Association’s site for professionals, for helpful resources. On the left, the site highlights key topics for diabetes professionals: meetings and CME opportunities, scientific sessions, webcasts, books for professionals, and more. On the right, the “Breaking News” and “Meeting Reports” provide quick access to the latest news in diabetes research and treatment developments. This ADA site for professionals also offers information about upcoming conferences, clinical practice guidelines, and research grants.

Link Code:a12611

Juvenile Diabetes Research Foundation International: For Scientists

In addition to research news, this site will also provide physicians with policy updates. Both sources of information will keep physicians updated about changes to clinical practice guidelines and provide the latest news to share with colleagues and patients and to use in research. The JDRF site for scientists also provides an extensive review of research and funding opportunities. Other areas of the JDRF site, such as “Life with Diabetes” and “Publications,” can be utilized by physicians to provide patients with information about diabetes management and treatment.

Link Code:a12612

//Clinical Trials

Exercise Training in Type 2 Diabetes and Hypertension

Study Type: Interventional

Age/Gender Requirement: 40-65 years (male/female)

Sponsor: National Institute of Diabetes and Digestive and Kidney Diseases

Purpose: To determine if the health of patients with both type 2 diabetes and hypertension improves with exercise training.

Link Code: a12661

Study of Intensive, Homebased Family Therapy to Improve Illness Management in Youth with Diabetes

Study Type: Interventional

Age/Gender Requirement: 10-17 years (male/female)

Sponsor: National Institute of Diabetes and Digestive and Kidney Diseases

Purpose: To determine if Multisystemic Therapy—home-based, family psychotherapy sessions 2-3 times a week—helps improve treatment adherence, metabolic control, and quality of life in children with diabetes.

Link Code: a12662


Ability of Traditional Lipid Ratios and Apolipoprotein Ratios to Predict Cardiovascular Risk in People with Type 2 Diabetes

Journal: Diabetologica (June 2010)

Authors: Taskinen M, Barter P, Ehnholm C, et al.

Purpose: To determine if the apolipoprotein B (ApoB):apolipoprotein A (ApoA)-I ratio should be used to indicate the need for lipid-lowering therapy.

Results: Lipid ratios and ApoB:ApoA-I performed better than any single lipid or apolipoprotein in predicting CVD risk, but these measurements were equally strong as predictors. The authors conclude that the data provided “little evidence for replacement of traditional lipids and their ratios with measures of ApoB, ApoA-I and their ratio.”

Link Code: a12651

Multinational Study in Children and Adolescents with Newly Diagnosed Type 1 Diabetes: Association of Age, Ketoacidosis, HLA Status, and Autoantibodies on Residual Beta-cell Function and Glycemic Control 12 Months After Diagnosis

Journal: Pediatric Diabetes (June 2010)

Authors: Mortensen H, Swift P, Holl R, et al.

Purpose: To identify predictors of residual beta-cell function and glycemic control within a year of the diagnosis of type 1 diabetes (T1D).

Results: Residual beta-cell function at 12 months was best determined by younger age, ketoacidosis at diagnosis, and insulin antibodies and glutamic acid decarboxylase antibodies (GADA) 1 month after diagnosis, while glycemic control at 12 months “was influenced predominantly by ethnicity, HbA1c at diagnosis, and GADA at 1 month.”

Link Code: a12652


Victoza (Liraglutide injection)

Medical Websites

Victoza Full Prescribing Information

This extensive guide to Victoza will provide physicians with important information about this injectable medication, designated specifically for adults with type 2 diabetes. More than 15 topics are discussed, including indications and usage, dosage forms and strengths, use in specific populations, and more. The extensive safety information covers contraindications, adverse reactions, overdose, and non-clinical toxicology. The final section of the guide is dedicated to patient counseling and includes information about proper handling of Victoza, laboratory tests, and possible side effects.

Link Code: a12613


Switching to Once-daily Liraglutide from Twice-daily Exenatide Further Improves Glycemic Control in Patients with Type 2 Diabetes Using Oral Agents

Journal: Diabetes Care (June 2010)

Authors: Buse J, Sesti G, Schmidt W, et al.

Purpose: To determine the safety and efficacy of switching from twice-daily exenatide to once-daily

liraglutide or of 40 weeks of continuous liraglutide therapy.

Results: Switching medications “further and significantly reduced A1C (0.32%), fasting plasma glucose (0.9 mmol/l), body weight (0.9 kg), and systolic blood pressure (3.8 mmHg) with minimal minor hypoglycemia (1.30 episodes/patient-year) or nausea (3.2%).” Among patients continuing with liraglutide, “further significant decreases in body weight (0.4 kg) and systolic blood pressure (2.2 mmHg) occurred with 0.74 episodes/patient-year of minor hypoglycemia and 1.5% experiencing nausea.” The authors conclude that “conversion from exenatide to liraglutide is well tolerated and provides additional glycemic control and cardiometabolic benefits.”

Link Code: a12653

From the HCPLive Network

Enterovirus Infection Linked to Type 1 Diabetes

Researchers at the University of Insubria in Varese, Italy have discovered a significant link between enterovirus infections and type 1, or juvenile, diabetes. More than four-fifths, 80%, of the 112 children included in the study, all of whom had type 1 diabetes, also had evidence of enterovirus infection in their blood. Though the study did not reveal a causal link between enteroviruses and diabetes, the results are “in tune” with earlier studies that have suggested enterovirus infections are associated with diabetes, according to the researchers.


Glucose-regulated Protein may Be Responsible for Mucormycosis Infection in Diabetics

Researchers at the University of California, Los Angeles, have discovered data in mice that may explain why patients with diabetes, particularly patients who also have diabetic ketoacidosis (DKA), are so susceptible to mucormyosis. The researchers aimed to determine “the endothelial cell receptor(s) for fungi of the order Mucorales, the fungi that cause mucormycosis,” according to the Journal of Clinical Investigation article on the study. The team discovered that the glucose-regulated protein 78 (GRP78) may be “a novel host receptor that mediates invasion and damage of human endothelial cells by Rhizopus oryzae, the most common etiologic species of Mucorales.”


Diabetes Watch

This collection of recent news items about diabetes discusses a number of topics, including the role of the pharmacist in reducing the costs of treatment and improving health outcomes, how calories and salt intake can increase the risk of retinopathy for diabetic patients, clinical updates from the American Diabetes Association, and more.


Current and Emerging Antihyperglycemic Treatment Options for Type 2 Diabetes

This paper reviews the complex nature of diabetes and the reasons why, despite 11 classes of medications, the disease can be so difficult to treat. Treatment goals, challenges, and specific medications, including glucose-lowering agents and incretin-based therapies, are also discussed.