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  • 1
    Online Resource
    Online Resource
    Weight Change During the Postintervention Follow-up of Look AHEAD
    American Diabetes Association ; 2022
    In:  Diabetes Care Vol. 45, No. 6 ( 2022-06-02), p. 1306-1314
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 45, No. 6 ( 2022-06-02), p. 1306-1314
    Abstract: Patients with type 2 diabetes are encouraged to lose weight, but excessive weight loss in older adults may be a marker of poor health and subsequent mortality. We examined weight change during the postintervention period of Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) with diabetes support and education (DSE) (control) in overweight/obese individuals with type 2 diabetes and sought to identify predictors of excessive postintervention weight loss and its association with mortality. RESEARCH DESIGN AND METHODS These secondary analyses compared postintervention weight change (year 8 to final visit; median 16 years) in ILI and DSE in 3,999 Look AHEAD participants. Using empirically derived trajectory categories, we compared four subgroups: weight gainers (n = 307), weight stable (n = 1,561), steady losers (n = 1,731), and steep losers (n = 380), on postintervention mortality, demographic variables, and health status at randomization and year 8. RESULTS Postintervention weight change averaged −3.7 ± 9.5%, with greater weight loss in the DSE than the ILI group. The steep weight loss trajectory subgroup lost on average 17.7 ± 6.6%; 30% of steep losers died during postintervention follow-up versus 10–18% in other trajectories (P & lt; 0001). The following variables distinguished steep losers from weight stable: baseline, older, longer diabetes duration, higher BMI, and greater multimorbidity; intervention, randomization to control group and less weight loss in years 1–8; and year 8, higher prevalence of frailty, multimorbidity, and depressive symptoms and lower use of weight control strategies. CONCLUSIONS Steep weight loss postintervention was associated with increased risk of mortality. Older individuals with longer duration of diabetes and multimorbidity should be monitored for excessive unintentional weight loss.
    Type of Medium: Online Resource
    ISSN: 0149-5992
    URL: Article
    DOI: 10.2337/dc21-1990
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1490520-6
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  • 2
    Online Resource
    Online Resource
    Intensive Glycemic Control Improves Long-term Renal Outcomes in Type 2 Diabetes in the Veterans Affairs Diabetes Trial (VADT)
    American Diabetes Association ; 2019
    In:  Diabetes Care Vol. 42, No. 11 ( 2019-11-01), p. e181-e182
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 42, No. 11 ( 2019-11-01), p. e181-e182
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc19-0891
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
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  • 3
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    Online Resource
    410-P: Therapeutic Profile from the Canadian REgistry of Chronic Kidney Disease in Diabetes Outcomes (CREDO) Study
    American Diabetes Association ; 2021
    In:  Diabetes Vol. 70, No. Supplement_1 ( 2021-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 70, No. Supplement_1 ( 2021-06-01)
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db21-410-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1501252-9
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  • 4
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    Online Resource
    The Rare and Atypical Diabetes Network (RADIANT) Study: Design and Early Results
    American Diabetes Association ; 2023
    In:  Diabetes Care Vol. 46, No. 6 ( 2023-06-01), p. 1265-1270
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 46, No. 6 ( 2023-06-01), p. 1265-1270
    Abstract: The Rare and Atypical Diabetes Network (RADIANT) will perform a study of individuals and, if deemed informative, a study of their family members with uncharacterized forms of diabetes. RESEARCH DESIGN AND METHODS The protocol includes genomic (whole-genome [WGS], RNA, and mitochondrial sequencing), phenotypic (vital signs, biometric measurements, questionnaires, and photography), metabolomics, and metabolic assessments. RESULTS Among 122 with WGS results of 878 enrolled individuals, a likely pathogenic variant in a known diabetes monogenic gene was found in 3 (2.5%), and six new monogenic variants have been identified in the SMAD5, PTPMT1, INS, NFKB1, IGF1R, and PAX6 genes. Frequent phenotypic clusters are lean type 2 diabetes, autoantibody-negative and insulin-deficient diabetes, lipodystrophic diabetes, and new forms of possible monogenic or oligogenic diabetes. CONCLUSIONS The analyses will lead to improved means of atypical diabetes identification. Genetic sequencing can identify new variants, and metabolomics and transcriptomics analysis can identify novel mechanisms and biomarkers for atypical disease.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc22-2440
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2023
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  • 5
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    Online Resource
    74-LB: Real-World Glycemic Outcomes in Adult Patients with Type 1 Diabetes Using a Real-Time Continuous Glucose Monitor Compared with an Intermittently Scanned Glucose Monitor and Self-Measured Blood Glucose—A Retrospective Observational Study from the Canadian
    American Diabetes Association ; 2022
    In:  Diabetes Vol. 71, No. Supplement_1 ( 2022-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: Real-time continuous glucose monitoring (rtCGM) and intermittently scanned CGM (isCGM) have both been shown to improve glycemic outcomes in people with T1D. In this retrospective analysis, we propensity score matched CGM naïve adults with T1D who initiated a rtCGM or an isCGM device. HbA1c and CGM metrics were assessed at 6-12-months. Among the 143 matched patients/cohort (age 43 ± 14 years; T1D duration 22 ± 14 years; HbA1c 8.4 ± 1.0%) , rtCGM users had a significantly greater change in HbA1c (-0.7 ± 0.1%) compared to isCGM users (-0.4 ± 0.1%) (p=0.01) . There was a significantly greater change in HbA1c for rtCGM compared to isCGM when baseline HbA1c was & lt;8.5% (difference -0.4% [-0.6 to -0.2], p & lt;0.001) , and in MDI users (difference -0.3% [-0.5 to 0.0], p=0.04) . Compared to isCGM users, rtCGM users had significantly greater time in range (58.3 ± 16.1% vs. 54.5 ± 17.1%, p=0.03) , lower time below range (2.1 ± 2.7% vs. 6.1 ± 5.0%, p & lt;0.001) and lower glycemic variability (Table) . In this real-world analysis of adults with T1D, rtCGM users had a significantly greater reduction in HbA1c at 6-12 months, significantly greater time in range, lower time below range, and lower glycemic variability, compared to a matched cohort of isCGM users. Disclosure R. E. Brown: None. L. Chu: None. G. J. Norman: Employee; Dexcom, Inc. A. Abitbol: Consultant; Amgen Inc., AstraZeneca, Bayer Inc., Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Novo Nordisk, Other Relationship; AstraZeneca, Bayer Inc., Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, Novo Nordisk, Sanofi, Senseonics. Funding DexCom Canada, Co.
    Type of Medium: Online Resource
    ISSN: 0012-1797
    URL: Article
    DOI: 10.2337/db22-74-LB
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
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  • 6
    Online Resource
    Online Resource
    48-LB: The Effect of Acute Psychosocial Stress in Adults with Type 1 Diabetes
    American Diabetes Association ; 2020
    In:  Diabetes Vol. 69, No. Supplement_1 ( 2020-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: The effects of acute psychological stress, heart rate variability (HRV), an indicator of autonomic function and glycemic variability (GV) have not been extensively researched in type 1 diabetes (T1D). The aim of this study is to explore the effect of acute psychosocial stress on HRV and GV in people with T1D. Methods: Eleven participants with T1D (33.00 ± 11.25 years) participated in the study. To assess acute mental stress, the subjects 1) participated in the Trier Social Stress Test (TSST); and 2) played competitive video games (Nintendo Switch™). The TSST followed standardized procedures whereby stress was induced asking participants to provide a job talk and arithmetic in front of two judges. Participants played the Mario Kart to go-kart races (10 minutes) and rotated their controllers to untangle the Treasure Chest (10 minutes). Resting HRV and GV were obtained. The subjects wore a continuous glucose monitor and a Zephyr Bioharness™ to record GV and HRV, respectively. Nonparametric, paired samples T-tests were conducted using SPSS 24. Results: During TSST, there were significant differences between the resting and TSST testing period in the sympathetic nervous sympathetic nervous system index (.57 ± 1.33 vs. 1.36 ± 1.40; z = -2.845, respectively; p & lt;.01; and stress index (8.17 ± 3.69 vs. 10.27 ± 5.69; z = -2.578, respectively; p & lt;.05). When subjects were playing video games, there were significant differences in the parasympathetic nervous sympathetic nervous system index (-.09 ± 1.75 vs. -.87 ± 1.05; z = -2.134, respectively; p & lt;.05) compared to a resting period. However, there were no significant differences in GV compared to a resting period in during TSST and playing video game. Conclusion: This study suggests that the TSST induced stress in people with T1D, increased sympathetic activity; however, the TSST did not change glycemic variability. Playing competitive video game did not appear to neither induces stress nor affected glycemic variability. The competitive video game did not cause stress compared to TSST. Disclosure M. Park: None. Y. Song: None. M. Chu: None. M. Sevil: None. N. Hobbs: None. L. Sharp: None. A. Cinar: Research Support; Self; Dexcom, Inc., JDRF. Stock/Shareholder; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S, Tandem Diabetes Care. L.T. Quinn: None. Funding JDRF
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db20-48-LB
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    Relation of Lipoprotein(a) Levels to Incident Type 2 Diabetes and Modification by Alirocumab Treatment
    American Diabetes Association ; 2021
    In:  Diabetes Care Vol. 44, No. 5 ( 2021-05-01), p. 1219-1227
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 44, No. 5 ( 2021-05-01), p. 1219-1227
    Abstract: In observational data, lower levels of lipoprotein(a) have been associated with greater prevalence of type 2 diabetes. Whether pharmacologic lowering of lipoprotein(a) influences incident type 2 diabetes is unknown. We determined the relationship of lipoprotein(a) concentration with incident type 2 diabetes and effects of treatment with alirocumab, a PCSK9 inhibitor. RESEARCH DESIGN AND METHODS In the ODYSSEY OUTCOMES trial alirocumab was compared with placebo in patients with acute coronary syndrome. Incident diabetes was determined from laboratory, medication, and adverse event data. RESULTS Among 13,480 patients without diabetes at baseline, 1,324 developed type 2 diabetes over a median 2.7 years. Median baseline lipoprotein(a) was 21.9 mg/dL. With placebo, 10 mg/dL lower baseline lipoprotein(a) was associated with hazard ratio 1.04 (95% CI 1.02−1.06, P & lt; 0.001) for incident type 2 diabetes. Alirocumab reduced lipoprotein(a) by a median 23.2% with greater absolute reductions from higher baseline levels and no overall effect on incident type 2 diabetes (hazard ratio 0.95, 95% CI 0.85–1.05). At low baseline lipoprotein(a) levels, alirocumab tended to reduce incident type 2 diabetes, while at high baseline lipoprotein(a) alirocumab tended to increase incident type 2 diabetes compared with placebo (treatment–baseline lipoprotein(a) interaction P = 0.006). In the alirocumab group, a 10 mg/dL decrease in lipoprotein(a) from baseline was associated with hazard ratio 1.07 (95% CI 1.03−1.12; P = 0.0002) for incident type 2 diabetes. CONCLUSIONS In patients with acute coronary syndrome, baseline lipoprotein(a) concentration associated inversely with incident type 2 diabetes. Alirocumab had neutral overall effect on incident type 2 diabetes. However, treatment-related reductions in lipoprotein(a), more pronounced from high baseline levels, were associated with increased risk of incident type 2 diabetes. Whether these findings pertain to other therapies that reduce lipoprotein(a) is undetermined.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc20-2842
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
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