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  • 1
    Online-Ressource
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    Sarcopenia Is Associated With Reduced Function on Admission to Rehabilitation in Patients With Diabetes
    The Endocrine Society ; 2021
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 106, No. 2 ( 2021-01-23), p. e687-e695
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 106, No. 2 ( 2021-01-23), p. e687-e695
    Kurzfassung: This work aims to estimate the prevalence of sarcopenia and to investigate the association between sarcopenia and functional performance in patients with and without diabetes admitted for inpatient rehabilitation. Materials and Methods Consecutive patients admitted to the subacute inpatient rehabilitation unit at St Vincent’s Hospital Melbourne, Australia (November 2016 to March 2020) were prospectively recruited into this cross-sectional study. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People 2018 algorithm. Participants’ functional performance was measured by the total Functional Independence Measure, motor Functional Independence Measure, and the Short Physical Performance Battery. The association between sarcopenia and functional performance was investigated using quantile regression. Results Of 300 participants, 49 (16%) had a history of diabetes and 44 (14.7%) were diagnosed with sarcopenia. No significant difference in the prevalence of sarcopenia between patients with or without diabetes was identified (11/49, 22.5% vs 33/251, 13.2%, P = .12). In patients with diabetes, those with sarcopenia had significantly reduced functional performance compared to those without sarcopenia on Functional Independence Measure, motor Functional Independence Measure, and the Short Physical Performance Battery, whereas in patients without diabetes no significant difference between patients with and without sarcopenia were identified for either functional performance measure (all P values for interaction & lt; .005). Conclusions The diagnosis of sarcopenia was associated with a reduced functional performance on admission to inpatient rehabilitation in patients with diabetes, but not in those without diabetes. Further investigation is needed into the progress of patients with dual diagnoses of diabetes and sarcopenia in inpatient rehabilitation.
    Materialart: Online-Ressource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/clinem/dgaa878
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: The Endocrine Society
    Publikationsdatum: 2021
    ZDB Id: 2026217-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Novel Therapies for Kidney Disease in People With Diabetes
    The Endocrine Society ; 2022
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 107, No. 1 ( 2022-01-01), p. e1-e24
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 107, No. 1 ( 2022-01-01), p. e1-e24
    Kurzfassung: The increasing burden of diabetic kidney disease (DKD) has led to the discovery of novel therapies. Objective This review aims to summarize the results of recent clinical trials that test the efficacy of potential therapies for DKD. Methods A systematized narrative review was performed utilizing the PubMed, Embase (Ovid), CINAHL, and Cochrane databases (January 2010 to January 2021). The included trials assessed the efficacy of specific medications using renal endpoints in adult participants with type 1 or 2 diabetes. Results Fifty-three trials were identified. Large, multinational, and high-powered trials investigating sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrated improved renal outcomes, even in patients with established DKD. Trials examining incretin-related therapies also showed some improvement in renal outcomes. Additionally, mineralocorticoid receptor antagonists exhibited potential with multiple improved renal outcomes in large trials, including those involving participants with established DKD. Atrasentan, baricitinib, ASP8232, PF-04634817, CCX140-B, atorvastatin, fenofibrate, probucol, doxycycline, vitamin D, omega-3 fatty acids, silymarin, turmeric, total glucosides of paeony, and tripterygium wilfordii Hook F extract were all associated with some improved renal endpoints but need further exploration. While bardoxolone methyl was associated with a decrease in albuminuria, high rates of cardiovascular adverse effects curtailed further exploration into this agent. Selonsertib, allopurinol, praliciguat, palosuran, benfotiamine, and diacerein were not associated with improved renal outcomes. Conclusion Trials have yielded promising results in the search for new therapies to manage DKD. SGLT2 inhibitors and incretin-related therapies have demonstrated benefit and were associated with improved cardiovascular outcomes. Mineralocorticoid receptor antagonists are another class of agents with increasing evidence of benefits.
    Materialart: Online-Ressource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/clinem/dgab639
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: The Endocrine Society
    Publikationsdatum: 2022
    ZDB Id: 2026217-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring
    The Endocrine Society ; 2022
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 107, No. 6 ( 2022-05-17), p. e2221-e2236
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 107, No. 6 ( 2022-05-17), p. e2221-e2236
    Kurzfassung: Although glycated hemoglobin A1c is currently the best parameter used clinically to assess risk for the development of diabetes complications, it does not provide insight into short-term fluctuations in glucose levels. This review summarizes the relationship between continuous glucose monitoring (CGM)-derived metrics of glycemic variability and diabetes-related complications. Evidence Acquisition PubMed and Embase databases were searched from January 1, 2010 to August 22, 2020, using the terms type 1 diabetes, type 2 diabetes, diabetes-related microvascular and macrovascular complications, and measures of glycaemic variability. Exclusion criteria were studies that did not use CGM and studies involving participants who were not diabetic, acutely unwell (post stroke, post surgery), pregnant, or using insulin pumps. Evidence Synthesis A total of 1636 records were identified, and 1602 were excluded, leaving 34 publications in the final review. Of the 20 852 total participants, 663 had type 1 diabetes (T1D) and 19 909 had type 2 diabetes (T2D). Glycemic variability and low time in range (TIR) showed associations with all studied microvascular and macrovascular complications of diabetes. Notably, higher TIR was associated with reduced risk of albuminuria, retinopathy, cardiovascular disease mortality, all-cause mortality, and abnormal carotid intima-media thickness. Peripheral neuropathy was predominantly associated with standard deviation of blood glucose levels (SD) and mean amplitude of glycemic excursions (MAGE). Conclusion The evidence supports the association between diabetes complications and CGM-derived measures of intraday glycemic variability. TIR emerged as the most consistent measure, supporting its emerging role in clinical practice. More longitudinal studies and trials are required to confirm these associations, particularly for T1D, for which there are limited data.
    Materialart: Online-Ressource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/clinem/dgac034
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: The Endocrine Society
    Publikationsdatum: 2022
    ZDB Id: 2026217-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Geometric Distortion Correction of Renal Diffusion Tensor Imaging Using the Reversed Gradient Method
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Computer Assisted Tomography Vol. 45, No. 2 ( 2021-3), p. 218-223
    Details
    In: Journal of Computer Assisted Tomography, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. 2 ( 2021-3), p. 218-223
    Kurzfassung: Renal echo planar diffusion tensor imaging (DTI) has clinical potential but suffers from geometric distortion. We evaluated feasibility of reversed gradient distortion correction in 10 diabetic patients and 6 volunteers. Renal area, apparent diffusion coefficient, fractional anisotropy, and tensor eigenvalues were measured on uncorrected and distortion-corrected DTI. Corrected DTI correlated better than uncorrected DTI ( r = 0.904 vs 0.840, P = 0.002) with reference anatomic T2-weighted imaging, with no significant difference in DTI metrics.
    Materialart: Online-Ressource
    ISSN: 1532-3145 , 0363-8715
    URL: Article
    DOI: 10.1097/RCT.0000000000001124
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2021
    ZDB Id: 2039772-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    A safety and pharmacodynamics study of temelimab, an antipathogenic human endogenous retrovirus type W envelope monoclonal antibody, in patients with type 1 diabetes
    Wiley ; 2020
    In:  Diabetes, Obesity and Metabolism Vol. 22, No. 7 ( 2020-07), p. 1111-1121
    Details
    In: Diabetes, Obesity and Metabolism, Wiley, Vol. 22, No. 7 ( 2020-07), p. 1111-1121
    Kurzfassung: To report the first study of temelimab, a monoclonal antibody neutralizing the pathogenic human endogenous retrovirus type W envelope, in patients with type 1 diabetes (T1D). Materials and Methods This double‐blind, placebo‐controlled, randomized clinical trial recruited adult patients with T1D within 4 years postdiagnosis and remaining C‐peptide secretion. Sixty‐four patients were randomized (2:1) to monthly temelimab 6 mg/kg or placebo during 24 weeks followed by a 24‐week, open‐label extension, during which all patients received temelimab. The primary objective was the safety and tolerability of temelimab. The secondary objective was to assess the pharmacodynamics response such as C‐peptide levels, insulin use, HbA1c, hypoglycaemia and autoantibodies. Results Temelimab was well tolerated without any group difference in the frequency or severity of adverse events. Concerning exploratory endpoints, there was no difference in the levels of C‐peptide, insulin use or HbA1c between treatment groups at weeks 24 and 48. The frequency of hypoglycaemia events was reduced with temelimab ( P = 0.0004) at week 24 and the level of anti‐insulin antibodies was lower with temelimab ( P 〈  0.01); the other autoantibodies did not differ between groups. Conclusions Temelimab appeared safe in patients with T1D. Pharmacodynamics signals (hypoglycaemia and anti‐insulin antibodies) under temelimab were observed. Markers of β‐cell functions were not modified by treatment. These results need to be further explored in younger patients with T1D with earlier disease onset.
    Materialart: Online-Ressource
    ISSN: 1462-8902 , 1463-1326
    URL: Issue
    URL: Article
    DOI: 10.1111/dom.v22.7
    DOI: 10.1111/dom.14010
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2020
    ZDB Id: 2004918-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Hospital‐acquired complications in intensive care unit patients with diabetes: A before‐and‐after study of a conventional versus liberal glucose control protocol
    Wiley ; 2019
    In:  Acta Anaesthesiologica Scandinavica Vol. 63, No. 6 ( 2019-07), p. 761-768
    Details
    In: Acta Anaesthesiologica Scandinavica, Wiley, Vol. 63, No. 6 ( 2019-07), p. 761-768
    Kurzfassung: Critically ill patients with diabetes mellitus (DM) are at increased risk of in‐hospital complications and the optimal glycemic target for such patients remains unclear. A more liberal approach to glucose control has recently been suggested for patients with DM, but uncertainty remains regarding its impact on complications. Methods We aimed to test the hypothesis that complications would be more common with a liberal glycemic target in ICU patients with DM. Thus, we compared hospital‐acquired complications in the first 400 critically ill patients with DM included in a sequential before‐and‐after trial of liberal (glucose target: 10‐14 mmol/L) vs conventional (glucose target: 6‐10 mmol/L) glucose control. Results Of the 400 patients studied, 165 (82.5%) patients in the liberal and 177 (88.5%) in the conventional‐control group were coded for at least one hospital‐acquired complication ( P  = 0.09). When comparing clinically relevant complications diagnosed between ICU admission and hospital discharge, we found no difference in the odds for infectious (adjusted odds ratio [aOR] for liberal‐control: 1.15 [95% CI: 0.68‐1.96] , P  = 0.60), cardiovascular (aOR 1.40 [95% CI: 0.63‐3.12], P  = 0.41) or neurological complications (aOR: 1.07 [95% CI: 0.61‐1.86], P  = 0.81), acute kidney injury (aOR 0.83 [95% CI: 0.43‐1.58], P  = 0.56) or hospital mortality (aOR: 1.09 [95% CI: 0.59‐2.02], P  = 0.77) between the liberal and the conventional‐control group. Conclusion In this prospective before‐and‐after study, liberal glucose control was not associated with an increased risk of hospital‐acquired infectious, cardiovascular, renal or neurological complications in critically ill patients with diabetes.
    Materialart: Online-Ressource
    ISSN: 0001-5172 , 1399-6576
    URL: Issue
    URL: Article
    DOI: 10.1111/aas.2019.63.issue-6
    DOI: 10.1111/aas.13354
    RVK:
    XA 11250
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2019
    ZDB Id: 2004319-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    The association between maternal renal function and pregnancy outcomes in type 1 and type 2 diabetes
    Elsevier BV ; 2020
    In:  Diabetes Research and Clinical Practice Vol. 165 ( 2020-07), p. 108225-
    Details
    In: Diabetes Research and Clinical Practice, Elsevier BV, Vol. 165 ( 2020-07), p. 108225-
    Materialart: Online-Ressource
    ISSN: 0168-8227
    URL: Article
    DOI: 10.1016/j.diabres.2020.108225
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 2020
    ZDB Id: 2004910-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Diabetic ketoacidosis in acromegaly; a rare complication precipitated by corticosteroid use
    Elsevier BV ; 2017
    In:  Diabetes Research and Clinical Practice Vol. 134 ( 2017-12), p. 29-37
    Details
    In: Diabetes Research and Clinical Practice, Elsevier BV, Vol. 134 ( 2017-12), p. 29-37
    Materialart: Online-Ressource
    ISSN: 0168-8227
    URL: Article
    DOI: 10.1016/j.diabres.2017.08.023
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 2017
    ZDB Id: 2004910-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Dietary sodium and potassium intake in people with diabetes: are guidelines being met?
    Springer Science and Business Media LLC ; 2020
    In:  Nutrition & Diabetes Vol. 10, No. 1 ( 2020-06-17)
    Details
    In: Nutrition & Diabetes, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-06-17)
    Kurzfassung: Despite public health bodies advocating for lowering dietary sodium and increasing potassium intake to improve cardiovascular outcomes, people with diabetes are not meeting these targets. We hypothesize that (i) both at an individual level and within the cohort, there will be a low adherence to the guidelines and (ii) sodium and potassium intake will remain stable over time. Methods We conducted this prospective study in a cohort of 904 participants with diabetes who provided 24-h urine collections from 2009 to 2015. Dietary sodium and potassium intake were estimated from 24-h urinary sodium (uNa) and potassium (uK) measurements. Additional data were collected for: 24-h urinary volume (uVol), creatinine (uCr),; serum creatinine, urea, estimated glomerular filtration rate (eGFR), glycated haemoglobin (HbA1c), fasting glucose, lipids); clinical characteristics (age, blood pressure (BP), body mass index (BMI) and duration of diabetes). Adherence to recommended dietary sodium (uNa  〈  2300 mg/24 h (100mmol/24 h)) and potassium (uK  〉  4680 mg/24 h(120 mmol/24)) intake were the main outcome measures. Results Participants ( n  = 904) completed 3689 urine collections (average four collections/participant). The mean ± SD (mmol/24 h) for uNa was 181 ± 73 and uK was 76 ± 25. After correcting uNa for uCr, 7% and 5% of participants met dietary sodium and potassium guidelines respectively. Males were less likely to meet sodium guidelines (OR 0.40, p   〈  0.001) but were more likely to meet potassium guidelines (OR 6.13, p   〈  0.001). Longer duration of diabetes was associated with higher adherence to sodium and potassium guidelines (OR 1.04, p   〈  0.001 and OR 0.96, p  = 0.006 respectively). Increasing age was significantly associated with adherence to potassium guidelines (OR 0.97, p  = 0.007). Conclusions People with diabetes do not follow current dietary sodium and potassium guidelines and are less likely to change their dietary intake of sodium and potassium over time.
    Materialart: Online-Ressource
    ISSN: 2044-4052
    URL: Article
    DOI: 10.1038/s41387-020-0126-5
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2020
    ZDB Id: 2609314-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    〈p〉Exploring the Relationship Between Maternal Circulating Hormones and Gestational Weight Gain in Women Without Obesity: A Cross-Sectional Study〈/p〉
    Informa UK Limited ; 2020
    In:  International Journal of Women's Health Vol. Volume 12 ( 2020-06), p. 455-462
    Details
    In: International Journal of Women's Health, Informa UK Limited, Vol. Volume 12 ( 2020-06), p. 455-462
    Materialart: Online-Ressource
    ISSN: 1179-1411
    URL: Article
    DOI: 10.2147/IJWH.S241785
    Sprache: Englisch
    Verlag: Informa UK Limited
    Publikationsdatum: 2020
    ZDB Id: 2508161-5
    Standort Signatur Einschränkungen Verfügbarkeit
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