The Net Guide: Type II Diabetes

//The Educated Patient™

Asian American Diabetes Initiative

Chinese diabetics have a higher ge¬netic risk of end-stage renal disease (http://hcp.lv/8XFkg6), but may not be aware of this. The Asian American Diabetes Initiative can help Chi¬nese patients find information that will help keep them on the path to healthy living and away from diabetic nephropathy. The site has newly ex¬panded content including an “Ask the Expert” section, an Interactive Wok, and the Joslinville Village of Health, available in Japanese, Chinese, and English.

Link Code: e12621

//Online CME

Increased Cardiovascular Disease Risk in Type 2 Diabetes: Pathophysiology

Credits: 1.00

Fee: None

Expiration Date: November 2010

Multimedia: Slides

This activity will review “the abun¬dant evidence for increased cardio¬vascular disease in patients with type 2 diabetes,” and “discuss the mecha¬nisms of vascular injury in diabetes, emphasizing the visceral adipocyte and its role in causing the metabolic syndrome.” Finally, the activity will cover global risk management.

Link Code: e12631

//eAbstracts

Sexuality among Middle Age and Older Adults with Diagnosed and Undiagnosed Diabetes

Journal: Diabetes Care (August 27, 2010)

Authors: Lindau S, Tang H, Gomero A, et al

Purpose: To “describe sexual activ¬ity, behavior, and problems among middle-age and older adults by diabe¬tes status.”

Results: More than “60% of partnered people with diagnosed diabetes were sexually active.” Women with dia¬betes were less likely than diabetic men and other women to be sexually active, and “were less likely to have discussed sex with a physician (11%) than women with diagnosed diabetes (19%), and men with undiagnosed (28%) or diagnosed (47%) diabetes.” Though “the prevalence of orgasm problems was similarly elevated among men with diagnosed and undiagnosed diabetes as compared to other men, erectile difficulties were elevated only among men with diagnosed diabetes.”

Link Code: e12651

Testing Covariates of Type 2 Diabetes-cognition Asso¬ciations in Older Adults

Journal: Neuropsychology (Sept. 2010)

Authors: McFall P, Geall B, Fischer A, et al

Purpose: The authors sought to “advance our understanding of Type 2 diabetes-cognition relationships in older adults by linking and test¬ing comprehensive sets of potential moderators, potential mediators, and multiple cognitive outcomes.”

Results: After identifying “13 health-related (but T2D-distal) potential covariates, representing four informal domains (ie, biological vitality, per¬sonal affect, subjective health, lifestyle activities),” researchers found that six were “sensitive to T2D associations with performance on seven cogni¬tive measures,” while three “(systolic blood pressure, gait-balance compos¬ite, subjective health) were significant mediators.” The authors believe that their findings hold “implications for future research across several fields of study and applications” including: 1) neuropsychological research on neural and biological bases of T2D-related

cognitive decline; 2) clinical research on intervention and treatment strate¬gies; 3) larger-scale longitudinal stud¬ies examining the potential multilat¬eral and dynamic relationships among T2D status, related comorbidities, and cognitive outcomes.

Link Code: e12652

Diabetes, Alzheimer Dis¬ease, and Vascular Demen¬tia. A Population-based Neuropathologic Study

Journal: Neurology (August 25, 2010)

Authors: Ahtiluoto S, Polvikoski T, Peltonen M, et al

Purpose: In order “to investigate the relation of diabetes to dementia, Al¬zheimer disease, and vascular demen¬tia,” researchers initiated the Vantaa 85 study which analyzed “incidence, mortality, and neuropathologic outcomes in a prospective population-based study of the oldest old.”

Results: After an initial examina¬tion, 553 residents of Vantaa, Finland, “aged ≥85 years on April 1, 1991” were “reexamined in 1994, 1996, 1999, and 2001,” and “autopsies were performed in 291 persons who died during the follow-up.” The authors found that “diabetes at baseline doubled the inci¬dence of dementia, Alzheimer disease, and vascular dementia, and increased mortality.” Although “individuals with diabetes were less likely to have β-amyloid and tangles,” they were “more likely to have cerebral infarcts after all adjustments.”

Link Code: e12653

//Newswatch

Breast Feeding Duration Linked to Type 2 Diabetes Risk

According to findings from the Reproductive Risk Factors for Incon¬tinence Study, “27% of mothers who did not [exclusively breast-feed their children for at least 1 month]…subsequently developed type 2 diabetes compared with mothers who breast-fed or women who did not give birth.” Eleanor Bimla Schwarz, MD, assistant professor of medicine, epidemiology, and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh, says that breast feeding helps reduce a mother’s diabetes risk by decreasing belly fat.

Link Code: e126111

Tim Tebow Don’t Know Nothin’

Denver Broncos third-string quarterback Tim Tebow claims that hyperbaric oxygen therapy (HBOT) helps him recover from the grueling demands of daily life in the NFL. The Cochrane Collaboration begs to differ. Their many meta-analyses have “found that the therapy is without efficacy” for stroke, multiple sclerosis, severe ear infections affecting bone, burns, muscle soreness, and sprains. In fact, it ap¬pears “that HBOT recipients suffering from muscle soreness ended up experiencing more pain.” A positive note for patients with diabetes: “the best evidence of efficacy is the use of HBOT in chronic wounds, especially related to diabetes.”

Link Code: e126112

From the Network

Fish Oils Work Swimmingly Against Diabetes, but why?

Researchers at the UC, San Diego School of Medicine have identified the molecular mechanism that makes omega-3 fatty acids so effective in reducing chronic inflammation and insulin resistance.

http://hcp.lv/bEM6ix

Alzheimer’s Plaques Prevalent in Insulin Resistance, Type 2 Diabetes

Though only 16% of patients with diabetes developed Alzheimer’s during a 15-year study, 65% had plaques at autopsy.

http://hcp.lv/aDRQag

NovoDose Helps Physicians Determine Insulin Needs

Novo Nordisk recently released an iPhone app meant to help physicians determine the insulin needs of their diabetic patients. It conveniently assumes you will be using Novo Nordisk’s insu¬lin analog product line which includes their long acting (Levemir), short acting (NovoLog) and their NovoLog Mix 70/30. The app is meant for health¬care professionals, but anyone may download it.

http://hcp.lv/cSfUbi

Rx Product News Profile: A Closer Look at New FDA Actions - Onglyza

Onglyza (saxagliptin), comarketed by Bristol-Myers Squibb and AstraZeneca, is FDA-approved to improve glycemic control for the treatment of type 2 diabetes.

http://hcp.lv/9gUGt1

Managed Care Pharmacy and the Evolving Diabetes Treatment Paradigm—Are We Capable of Disease Control?

This supplement to The American Journal of Managed Care reviews the efficacy and safety of incretin-based therapies in type 2 diabetes, discuss¬es barriers to effective management of this disease, and describes strategies and interventions that can be implemented by managed care to ensure optimal outcomes.

http://hcp.lv/a1zYFO

Cost Sharing, Adherence, and Health Outcomes in Patients With Diabetes

Higher cost-sharing levels reduced adherence to antidiabetic medications in patients with type 2 diabetes.

http://hcp.lv/b8S5rD

Care Fragmentation and Emergency Department Use Among Complex Patients With Diabetes

Fragmentation of care to specialists may be associated with higher rates of emergency depart¬ment visits among patients with chronic illness.

http://hcp.lv/9AwS3e

Pharma Focus

Januvia (sitagliptin)

//Clinical Trials

The Effects of Co-administration of Colesevelam and Sitagliptin on Glucose Metabolism in Subjects with Type 2 Diabetes Mellitus

STUDY TYPE: Interventional

AGE/GENDER REQUIREMENTS: 18-80 years (male/female)

SPONSOR: KineMed

PURPOSE: Investigators will evaluate the effects of a colesevelam/sitagliptin combination therapy on HbA1c, glucose pathways, insulin, C-peptide, GLP-1, GIP, and glucagon concentrations.

LINK CODE: e12661

The Effect of Januvia on Oxidative Stress in Obese Type 2 Diabetic Subjects

STUDY TYPE: Interventional

AGE/GENDER REQUIREMENTS: 20-75 years (male/female)

SPONSOR: Kaleida Health

PURPOSE: “To investigate that therapy with sitagliptin orally daily (100 mg) for 12 weeks decreases reactive oxygen species generation by MNC, protein and mRNA expression of p47phox subunit of NADPH oxidase, and oxidized lipids…in plasma and F2-isoprostane in urine of type 2 diabetic patients.” Subjects in a second arm will be given a placebo for 12 weeks.

LINK CODE: e12662