Category Archives: Diabetes

Among people with type 2 diabetes (T2D) attending diabetic retinopathy (DR) screening in Denmark, markers including insulin use were important predictors for the development of present, incident, and progressive DR.

A multivariable model indicated that patients who used insulin were 2.3 times more likely to have DR and they had a 1.92.4 times higher risk for DR-development or progression, while the use of cholesterol-lowering medicine was associated with a lower presence of DR.

However, through the follow-up period in 2013 2018, the nationwide cohort reported a considerably lower prevalence, incidence, and progression of DR, when compared with earlier reports.

Potential explanations for this might include that the recent years have led to better treatment and optimized risk factor control in diabetes, which might decrease the onset and progression of DR, said Jakob Grauslund, MD, PhD, Department of Ophthalmology, Odense University Hospital.

Duration of diabetes was reported as a leading indicator of DR and proliferative DR (PDR), being 2.45 and 9.79 times more frequent in patients with a duration of more than 20 years than those who were diagnosed within 10 years.

The team of investigators evaluated the prevalence and incidence of DR along with associated markers in patients with type 2 diabetes in the Danish DR-screening program between 2013 and 2018. Stages of DR were defined according to the International Clinical Diabetic Retinopathy Disease Severity Scale as levels 0 (no DR), 13 (mild, moderate, and severe non-PDR), or 4 (PDR).

Investigators linked data from the national Danish Registry of Diabetic Retinopathy (DiaBase) to various national health registries in order to retrieve information on diabetes duration, marital status, comorbidity, insulin use, and systemic medication.

The study included all 153,238 people with T2D (56.4% male) from the study period, with a mean age of 66.9 years and duration of diabetes at 5.3 years.

The rates of use of insulin, non-insulin glucose lowering drugs, blood pressure lowering therapy and cholesterol lowering therapy at the first screening episode were reported as 15.8%, 86.5%, 77.8%, and 77.3%, respectively. Most patients did not have DR at their first screening (91.2%).

The prevalence and 5-year incidences of DR, 2-step-or-more progression of DR and progression to PDR were 8.6%, 2.8%, 0.7%, and 0.2%, respectively.

Multivariable regression models indicate the prevalence of DR was associated with male sex (odds ratio [OR], 1.30; 95% CI, 1.25 1.36), age (OR, 0.77; 95% CI, 0.74 - 0.81 per 10 years of age), duration of diabetes (OR, 3.07; 95% CI, 2.96 3.18 per 10 years), and the use of insulin (OR, 2.34; 95% CI, 2.24 - 2.44).

The prospective part of the study determined the leading marker of incident DR and progression to PDR were duration of diabetes (hazard ratio [HR], 1.98; 95% CI, 1.87 - 2.09; HR, 2.89, 95% CI, 2.34 - 3.58 per 10 years of duration) and use of insulin (HR, 1.88; 95% CI, 1.76 - 2.01; HR, 2.40, 95% CI, 1.84 - 3.13).

Meanwhile, the use of cholesterol-lowering medication was considered a protective marker (HR, 0.87; 95% CI, 0.81 0.93; HR, 0.70; 95% CI, 0.52 - 0.93).

The study, Presence and development of diabetic retinopathy in 153,238 patients with type 2 diabetes in the Danish Registry of Diabetic Retinopathy, was published in Acta Ophthalmologica.

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Insulin Use May Predict the Development of Diabetic Retinopathy - MD Magazine

Type 1 diabetes is a condition that they both say is tough to deal with, not because of the physical ailments, but the social anxieties while at school.

CUYAHOGA COUNTY, Ohio Olivia and Marabelle are two Northeast Ohio teens that many would describe as typical teenagers.

If it wasn't for the beeping of their insulin pumps, you'd never know about the daily routine that has become just another part of their every day life.

Oliva and Marabelle were both born with type 1 diabetes.

A condition that they both say is tough to deal with, not because of the physical ailments, but the social effects they deal with while relying on those insulin pumps.

They don't try to do anything to bring attention to their condition while in school, but the loud beeping of the pumps bring attention to them whether they want it or not.

Oliva said, "When my pump would beep [in class], kids would freak out. When does it usually go off if my blood sugar is high or low. Or sometimes if I forget to turn my insulin back on after a shower.

They say it hasn't only been a struggle with feeling different compared to their classmates, but incidents with teachers thinking their devices are cell phones being used in class causes anxiety when the machines are working to provide them their necessary medicine.

Oliva continued, "One time I was giving myself insulin in class, my teacher was walking around and said 'Do I see a phone?' The whole class turned around. She looked under my desk and saw my pump and said, 'never mind'"

Technology has come a long way in helping children born with type 1 diabetes manage their insulin intake. Phones now connect to pumps via Bluetooth and help monitor blood sugar levels easier than ever before.

However one issue that still remains that technology hasn't come up with a solution for, the social ramifications of feeling "different" in a way not many others can understand.

Marabelle's mother Kari says schools are made aware of conditions like type 1 diabetes and should make sure every staff member knows about the accommodations allowed to these students by law.

"When [students] have something similar [to type 1 diabetes] they get a 504 plan through the school that gives them extra accommodations for test taking if they are over 300 they have the option to postpone. If they are not aloud to eat in class they can because they need it to stay healthy.

More than 200,000 kids have type 1 diabetes in the United States. It is an every day battle to stay healthy not only physically, but mentally and emotionally too.

Marabelle shares that she just wants to be looked as as a normal teen, "I'm not as different as you think I can still do normal stuff and that my pump beeping isn't a big deal."

The Juvenile Diabetes Research Foundation (JDRF) will be holding its "One Walk" event coming up on Sunday, October 16 at Cleveland Metroparks Zoo. Money raised for the event will go towards JDRF's battle to conquer type 1 diabetes. Click here to register or make a donation.

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2 Northeast Ohio teens born with type 1 diabetes deal with social anxieties of their condition at school - WKYC.com

What and how you eat directly impacts your risk of developing type 2 diabetes. So, it's simple logic to make a habit of reducing the stuff that most directly leads to the deadly disease: sugar.

An estimated 34 million Americans have diabetes, more than 10% of the U.S. population, according to the National Institutes of Health. Another 88 million adults or 34.5% of Americans have prediabetes, a disorder characterized by blood sugar levels that are high but not yet to the level indicating type 2 diabetes.

When your body doesn't produce enough insulin or uses it ineffectively to keep your blood sugar in a healthy range, that's called insulin resistance. Your cells become numb to the hormone and can't efficiently use glucose for energy. Insulin resistance often leads to type 2 diabetes.

The disease is so common (as the numbers above suggest) that many people may not be aware of how serious and frightening it is. Type 2 diabetes is associated with obesity, cardiovascular disease, nonalcoholic fatty liver, and dementia.

If understanding the devastating potential outcomes of a diabetes diagnosis has renewed your interest in being more aware of your sugar intake, great! But here's another idea: Instead of focusing on cutting carbs and sugars out of your diet, establish eating habits that prevent diabetes. Since sacrificing the foods you love can be so unpleasant, focus on how you can eat healthy without denying yourself. That gets to the most crucial eating habit for avoiding diabetes, according to many nutrition experts:

"The diet we should all be on is the optimal diet of people with diabetes," says registered dietitian nutritionist Wendy Bazilian, Dr.PH, RDN, a doctor of public health and exercise physiologist certified by the American College of Sports Medicine. "You want a stable, steady release of blood glucose to enter the cells to make energy efficiently."

This is because stable blood sugar is critical to optimal metabolic health. And it affects many facets of your overall healthyour energy, sleep, mood and cognition, and immune system function.

"Uneven eating patterns, like skipping meals and eating heavily at dinner because you're starving, cause too many blood sugar spikes, which increases risk for diabetes," says registered dietitian Catherine Sebastian, MS, RD, manager of health communications at The Wonderful Company.

That advice may sound radical, but it's very logical and doable, because it's essentially the same healthy eating style that supports heart health, reduces inflammation, prevents weight gain and obesity, and reduces risk of certain cancers.

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Another important thing to consider when "eating like you already have diabetes" is that you don't need to cut out carbs completely.

"Cutting out carbs is a misconception," says Sebastian. "You want carbohydrates that contain fiber. And you should always have a protein source in every meal."

And some fat, adds Dr. Bazilian. "Have protein, fat, and carbs in your meal." Having the three macronutrients ensures you're getting nutrients, including fiber, that slow the absorption of sugars into the bloodstream as well as promote satiety.

Making a habit of eating like someone who already has diabetes can be challenging, just as establishing any routine can be. The key is to make a decision to commit to your health and well-being before making any changes to your day-to-day life, says Nick Frye, MS, a licensed clinical professional counselor and behavioral counseling manager for OPTAVIA, a weight loss and health coaching company.

The first step is finding your "why," "which is what we call the fundamental choice," he says. "It's an intentional commitment to identifying and following your north star. It's a mindset shift that sets direction and foundation for future action. All other habits to come are made in service to your fundamental choice."

So, for example, if eating like a diabetic is the habit you want to adopt, the first step is to determine what you want to get out of that habit. If it's "to optimize my health and avoid diabetes," personalize it with something emotionally meaningful to you, like "so I can be healthy enough to dance at my granddaughter's wedding in 20 years."

"Mindfully and intentionally become the author of your story," suggests Frye. "Skipping this mental exercise and jumping prematurely into action may deliver temporary success but is likely to result in long-term failure."

Remember Newton's First Law of Motion? A body at rest will remain at rest unless acted upon by an outside force. Well, that's the principle behind habit creation: you must start moving and then keep moving. Frye recommends starting small with micro-habits because "small, repeatable behaviors lead to significant results. Habits set people up for sustainable change."6254a4d1642c605c54bf1cab17d50f1e

You can find advice on how to eat like a diabetic on the American Diabetes Association website and elsewhere. But to start, build these micro-habits into your day and see where they take you.

"Put something in your mouth, break your fast," advises Carly Knowles, MS, RDN, a registered dietitian nutritionist with Organic Valley, an independent cooperative of organic farmers. "It fixes so much. It sets a mindset shift that food is a priority."

Knowles also works in private practice with women with gestational diabetes. She says her golden piece of advice to them is to eat for energy in the morning. "It's not so important what you eat but that you eatcould be five almonds or a few spoonfuls of yogurtsomething. Otherwise, you may get to lunch with a blood sugar crash, causing brain fog, cravings, and binge eating."

If you're trying to avoid white bread by switching to 100% whole wheat but are having trouble making the switch, go half and half. "Make half of your daily grains whole grains and half refined grains that are enriched," suggests Elana Natkier, MS, RD, a registered dietitian and consultant to the Grain Foods Foundation.

Eating the enriched bread won't increase your risk of diabetes, and it will ensure you're getting the added iron, folate, vitamin A, and thiamine. Natkier points to a 2019 analysis of studies in Advances in Nutrition, which found no association between refined grain intake and risk of type 2 diabetes when comparing the highest and lowest intake groups.

Brazilian also recommends establishing this micro-habit: Stand up after you finish a meal. The act alone marks a transition and signals to your brain that the meal is completed. "Standing up starts the mechanics of digestion and it starts to tell our cells to open up to receive blood sugar," Bazilian adds. For the same reason, go for a walk after every meal. She cites a study in Sports Medicine, showing that even just two minutes of walking after a meal can improve blood sugar levels when compared to sitting or laying down.

Have a glass of water before every meal. It'll likely satisfy the intense hunger and help you avoid overeating. "Eating too much food can also make your blood sugar out of balance," says Bazilian. Too much of any one macronutrient can be detrimental to health, too.

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The Most Crucial Eating Habit To Prevent Diabetes - Eat This, Not That

Newswise CLEVELAND University Hospitals has received national recognition, with two awards from the American Heart Association and other entities, for its care of patients with uncontrolled blood pressure, diabetes, heart disease, and stroke. These are some of the most common and devastating conditions plaguing the health of Americans today. The UH Primary Care Institute (PCI) and UH Population Health drove this effort.

High blood pressure (BP), or hypertension, is a leading risk factor for heart attacks, strokes, and preventable deathin the U.S. Nearly half of all adults in the country, 121.5 million people, are living with hypertension. Unfortunately, according to a study published in the Journal Circulation, less than half of them have their BP under control. Furthermore, Black Americans are more likely to have hypertension and suffer harm from it.

More than 37 million Americans have diabetes, and cardiovascular disease (CVD) is the leading cause of death for people living with type 2 diabetes. CVD is the leading cause of death and a major cause of heart attacks, strokes and heart failure for people living with type 2 diabetes.

Addressing blood pressure management is key for better cardiovascular health and is critical today, when heart disease and stroke continue to be leading causes of death for adults in the U.S., said Todd Zeiger, MD, who led this effort and at the time was Quality Medical Director for the Primary Care Institute at University Hospitals. Sona Kirpekar, MD, now leads quality for PCI. Receiving this recognition is a testament to the community that when they trust University Hospitals with their health, they will receive quality care.

At UH, were committed to optimizing care for the entire population of patients we serve, keeping them well and out of the hospital, said Peter Pronovost, MD, PhD, Chief Quality and Clinical Transformation Officer at UH. On our journey to zero harm, we are working diligently to ensure all patients have their blood pressure controlled. Were grateful to our primary care and other providers whove played such a significant role in making this happen as well as their patients whove committed to pursuing a healthier lifestyle.

These improvements are the result of an interdisciplinary effort where UHs Accountable Care Organization Population Health team, nurses, medical assistants, pharmacists, and PCI physicians work collaboratively to ensure patients have their blood pressure and diabetes controlled.This endeavor is one of several new ways in which UH seeks to optimize the care of patients with chronic disease by engaging primary care practices with specialists and patients to design primary care-centered resources around their needs.

Target: BP Gold+ Award

The American Heart Association and American Medical Association have awarded University Hospitals with the Target: BP Gold+ Award for its commitment to improving blood pressure control rates. The Gold+ award recognizes practices that demonstrate a commitment to measurement accuracy and in which high blood pressure is controlled in 70 percent or more of the affected adult patients.

Target: BP is a national collaboration between the American Heart Association and American Medical Association aimed at reducing the number of adults in the U.S. who suffer from heart attacks and strokes each year by urging physician practices, health systems, and patients to prioritize BP control.

Target: Type 2 Diabetes Participant Award

UH has also received the American Heart Associations Target: Type 2 Diabetes Participant Award for its commitment to addressing the relationship between diabetes and the risk of heart disease and stroke. The Participant Award recognizes practices that have completed data submission, including clinical measure entry, and committed to improving quality of care for patients with type 2 diabetes and cardiovascular risk factors.

Target: Type 2 Diabetes addresses heart disease and stroke risk factors in patients with type 2 diabetes as part of the Know Diabetes by Heart initiative, by the American Heart Association and American Diabetes Association, helping ensure the care provided to patients is aligned with the latest evidence- and research-based guidelines.

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About University Hospitals / Cleveland, Ohio Founded in 1866, University Hospitals serves the needs of patients through an integrated network of more than 20 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio.The systems flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Oxford University and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top childrens hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including Americas Best Hospitals from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH isone of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visitUHhospitals.org.

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University Hospitals nationally recognized for efforts to reduce uncontrolled blood pressure; address relationship between diabetes, heart disease,...

Tandem Diabetes Care TNDM has observed the following analyst ratings within the last quarter:

According to 5 analyst offering 12-month price targets in the last 3 months, Tandem Diabetes Care has an average price target of $75.2 with a high of $90.00 and a low of $49.00.

Below is a summary of how these 5 analysts rated Tandem Diabetes Care over the past 3 months. The greater the number of bullish ratings, the more positive analysts are on the stock and the greater the number of bearish ratings, the more negative analysts are on the stock

This current average represents a 38.99% decrease from the previous average price target of $123.25.

Ratings come from analysts, or specialists within banking and financial systems that report for specific stocks or defined sectors (typically once per quarter for each stock). Analysts usually derive their information from company conference calls and meetings, financial statements, and conversations with important insiders to reach their decisions.

Some analysts publish their predictions for metrics such as growth estimates, earnings, and revenue to provide additional guidance with their ratings. When using analyst ratings, it is important to keep in mind that stock and sector analysts are also human and are only offering their opinions to investors.

If you want to keep track of which analysts are outperforming others, you can view updated analyst ratings along withanalyst success scores in Benzinga Pro.

This article was generated by Benzinga's automated content engine and reviewed by an editor.

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5 Analysts Have This to Say About Tandem Diabetes Care - Tandem Diabetes Care (NASDAQ:TNDM) - Benzinga

Youve probably heard of diabetes. And obesity. But what the heck is diabesity? Its a new medical term for a condition thats becoming a worldwide epidemic. And if you have it, losing weight could cure the condition. Endocrinologist Jay Waddadar, MD, explains.

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Diabesity isnt an official diagnosis. It means you have both obesity and Type 2 diabetes. Together, these closely related conditions greatly increase your risk of heart disease the leading cause of death in the country.

Diabesity is a disease with enormous potential to cause ill effects on the body in the long run, says Dr. Waddadar. Some people dont understand the importance of taking the steps to manage it because theyre feeling well at the time of diagnosis. But thats a big mistake. Diabesity is a silent disease that damages your body if its not controlled, even while you feel fine.

The good news: You can prevent, control and even reverse it. Dr. Waddadar shares more about how obesity causes and worsens diabetes. And why losing weight holds the key to possibly making it all go away.

Having obesity makes you more likely to develop diabetes, the condition of having too much glucose (sugar) circulating in your bloodstream. Obesity also causes diabetes to worsen faster.

Heres what happens: Managing the level of glucose in your blood is the job of the pancreas. The pancreas creates insulin, which is a hormone that moves glucose out of your blood. Normally, insulin transports glucose to your muscles to use right away for energy or to the liver, where its stored for later.

But when you have diabesity, your cells resist letting insulin move glucose into them. To make matters worse, the area of your liver where excess glucose is usually stored is filled with fat. Its like trying to put furniture in a room thats already packed. Theres no space for anything else, Dr. Waddadar explains.

With nowhere to be stored, the glucose remains in the bloodstream. So your pancreas creates even more insulin trying to accomplish the job of moving glucose out of the blood, says Dr. Waddadar. Its trying to push against the resistance created by the fat. Your pancreas becomes overworked, and as a result, it wears out. It starts producing less insulin. Diabetes develops and then quickly worsens if the fat resistance remains.

If you have obesity, youre about six times more likely to develop Type 2 diabetes than those at a healthy weight. But not everyone with obesity automatically gets diabetes. Other factors are likely at play, too, including:

It may be that some people with obesity can produce more insulin without overtaxing the pancreas, says Dr. Waddadar. Others might be limited in insulin production, making it more likely that obesity will lead to diabesity.

Since excess fat worsens diabetes, losing weight can greatly improve the condition. When you have diabesity, you may start with one medication to get the pancreas to produce enough insulin. But very soon and much earlier, you need two or more medicines for diabetes. But if you lose weight, you may do fine with just one medication or even go off medication entirely, explains Dr. Waddadar.

Losing as little as 5% to 10% of your overall body weight can greatly improve Type 2 diabetes. For example, if you weigh 200 pounds, 5% of that is 10 pounds. So bringing your weight down to 190 pounds can significantly help your health. The first treatment goal for diabesity is to get to and maintain a healthy weight along with eating a low-carb diet, Dr. Waddadar says.

Changing your diet and increasing exercise to lose weight can be challenging. But the hard work is worth it to avoid serious complications of uncontrolled diabetes like heart disease, kidney failure and nerve damage.

Ready to take the first step toward better health? Ask your doctor for resources and guidance to help you beat diabetes.

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Cleveland Clinic

A diabetes diagnosis will require a person to make numerous changes to their lifestyle and routines. However, devising and sticking to a good treatment plan can help someone maintain a sense of agency around their condition and high quality of life.

Living with diabetes requires a person to eat a healthy diet, remain active, manage their symptoms, and know the signs of diabetic health issues.

Diabetes is a chronic illness that affects the bodys ability to convert glucose from food into energy, and it has three prominent types. Type 2 diabetes usually presents in adulthood and is the most common form, accounting for about 90% of all diabetes diagnoses. It causes insulin resistance, which means that the bodys insulin is not as effective at turning glucose into energy as it should be.

People with diabetes must develop strategies for managing their blood glucose, maintaining a moderate weight, and preventing complications like circulatory health problems and infections. Lifestyle changes, diabetes education, and medication can help a person living with diabetes achieve their best possible health outcomes and quality of life.

Read on to learn more about living with diabetes.

All forms of diabetes affect the bodys ability to convert glucose to energy using insulin. The three main types of diabetes include:

Because diabetes affects the bodys ability to metabolize glucose, high glycemic index foods are more likely to increase a persons blood glucose and cause diabetes complications. This means they should reduce sweetened, processed foods and simple carbohydrates, such as white bread and white pasta, from their diet.

Instead, a person should focus on eating nutrient-dense foods. Some other strategies for a healthier diet include:

People with type 2 diabetes often carry excess weight or have obesity. This can increase their risk of diabetes complications, such as heart disease. Exercise may help a person achieve or maintain moderate body weight.

Exercise can also increase the bodys sensitivity to insulin, which can improve a persons diabetes symptoms and support healthy blood glucose levels. Unless a doctor has specifically told a person not to exercise, almost everyone can benefit from exercise. More exercise generally offers more benefits.

The Centers for Disease Control and Prevention (CDC) recommends a minimum of 150 minutes of moderate-intensity physical activity per week. Some strategies for increasing a persons activity levels include:

Because people with type 1 diabetes do not produce enough insulin, they need insulin treatment. A person may need to give themselves insulin injections or use an insulin pump.

People with type 2 diabetes and gestational diabetes may need insulin if they cannot control their blood glucose with lifestyle changes alone.

Several other medications may also help a persons diabetes symptoms when insulin alone does not work. Some drug classes a doctor may recommend include:

A person might also need medication for diabetes-related complications. Some common drugs include:

It can take time to make the healthy changes that diabetes requires. A person should focus on making incremental changes that steadily improve their health. A routine may make these changes easier. Some strategies for building a healthy routine include:

Major life changes can affect a persons routine, making it more difficult to maintain a healthy lifestyle. For example, when a person is sick, they may be less able to exercise or make healthy meals.

When life changes disrupt a persons routine, consider slowly reincorporating healthy habits one by one. Small changes matter and add up. Also, finding alternative ways to maintain a healthy lifestyle can be helpful.

For example, a person working long hours, who cannot exercise, can still eat healthy meals. They might also take frequent breaks to walk or stretch during audio calls.

Various physiological changes throughout of a persons life may also affect their diabetes symptoms and management.

For instance, stress can influence a persons blood glucose levels. Menopause may affect the bodys insulin secretion ability and sensitivity, too. However, hormone replacement therapy has positive effects on a persons blood sugar levels. It is important to talk with a doctor about how major life changes may affect a persons diabetes and ways to best reduce any negative effects.

A person with diabetes will need support to make necessary lifestyle changes. Moreover, insulin injections and regular medical appointments may feel stressful or overwhelming. Some strategies for finding the right support include:

Diabetes is a chronic illness that often gets worse with time, especially without effective treatment or healthy lifestyle changes.

Both genetic and environmental factors play a role in the development and progression of diabetes. Therefore, even with a healthy lifestyle, a person may require medication and ongoing medical support.

People with diabetes should find a doctor they like and trust to help them develop a comprehensive plan for living with diabetes.

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Living with diabetes: Nutrition, exercise, routines, and more - Medical News Today

Researchers at GW hosted clinical trials for four diabetes drugs and found two type 2 diabetes treatments were more effective than others at lowering blood glucose levels in a study published late last month by the National Institutes of Health.

The clinical trials hosted by GW and funded by the National Institutes of Health are a part of a study which found patients who received the drugs liraglutide and insulin glargine, which control blood sugar levels, experienced controlled blood glucose levels for about six months longer than patients who received the other two drugs in the trial. Researchers said the study, titled Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness gives two more treatment options for patients and healthcare providers to lower patients blood glucose levels.

John Lachin, a professor of biostatistics and bioinformatics at GW and the senior statistician for the GRADE study, said the drugs worked immediately in lowering patients blood glucose levels, and lowered patients likelihood of developing diabetes-related cardiovascular disease. But he said he was disappointed in the results of the study because the effectiveness of the drugs dropped after six months.

I, for one, am somewhat disappointed that the study wasnt able to do better, Lachin said. And its not the fault of the study. Its the drugs we chose to use just simply werent as good in the long term as we had hoped they would be.

Lachin said the GRADE study, which lasted for eight years, helped fulfill a need for long-term research on existing diabetes treatments. He said researchers test type 2 diabetes treatments for about six to 12 months when they are undergoing Food and Drug Administration approval, short-term research that is insufficient to study the durability of these medicines since diabetes is generally a lifelong disease.

We felt that it was very important to obtain an assessment of the properties of these drugs over a longer window, Lachin said.

The GRADE study is the first to test four popular type 2 diabetes drugs against each other without a placebo, according to the NIH.

The study also found that when metformin an antidiabetic medication combines with the higher-performing drugs of the study, it results in effective glucose levels about six months longer than patients who took sitagliptin, an antidiabetic medication.

Lachin said GWs Biostatistics Center received funding for the study from the NIH, provided a statistical design and collected and analyzed the data. He said the trials can help procure research funds that can attract first-rate biostaticians and professors to teach at GWs Biostatistics Center because GW has the resources to lead major projects like the GRADE study trials.

At GW, weve established systems and procedures so that we excel in our ability to coordinate and conduct these studies, Lachin said.

Metformin the primary medicine prescribed for type 2 diabetes is often insufficient to keep blood glucose levels in check alone, and other drugs, like the four tested in the GRADE study in combination with metformin, are needed to supplement it.

GRADE study researchers said they hope the study opens up opportunities for future research in the field of diabetes and gives healthcare providers more treatment options.

David Nathan, a professor at Harvard Medical School and the director of the Massachusetts General Hospital Diabetes Center, said he served as the chair of the GRADE study since its creation more than a decade ago and worked with Lachin during the GW trials. Nathan said he constructed the study to compare new and older drugs instead of testing against placebos like other studies do.

Nathan said further research is needed to perfect treatment for type 2 diabetes, because none of the treatments proved to be particularly effective in keeping patients in the target blood glucose range through the entire eight-year period.

What that means is that we need to generate new treatments and new strategies for treating these folks, Nathan said. Type 2 diabetes is really hard to take care of, and thats kind of one of the overarching messages that we came out with.

Robert Cohen, a site investigator for the GRADE study and a professor of medicine at the University of Cincinnati, said patients taking metformin and liraglutide were the least susceptible to cardiovascular disease, but also experienced the highest rates of gastrointestinal symptoms. He said patients using the drugs in the trials were more likely to experience low blood sugar levels and the fraction of people who experienced extreme side effects from the drugs was remarkably small.

Do we have the answer with the tools that we have available? Or do we need new drugs? Cohen said. So I think in that sense, GRADE is going to affect policy decisions about driving the research community to develop new classes of drugs.

Cohen said type 2 diabetes treatment has improved in the last 25 years due to the creation of new drugs and more aggressive goals toward treatments. He said even though doctors have made improvements in diabetes medicine, most drugs arent effective at maintaining blood glucose levels on a long-term basis and the study can provide alternative options for controlling glucose levels.

I am hoping that we are going to come out with some sort of personalized medicine approaches based on the implications of GRADE, Cohen said.

This article appeared in the January 10, 2022 issue of the Hatchet.

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Researchers study long-term effectiveness of diabetes drugs - GW Hatchet

After 12 years of serving more than 11,500 college students on over 300 campuses nationwide, the College Diabetes Network is expanding and rebranding to The Diabetes Link in effort to serve more young adults

BOSTON, Oct. 3, 2022 /PRNewswire/ -- Currently, there are 3 million young adults (ages 17-30) living with diabetes in the U.S. and that number continues to increase every day. The Diabetes Link is the only national organization that focuses specifically on people in their teens and twenties, in recognition that this time of their lives is full of enough change and challenges without a chronic disease added to the mix.

Formerly known as the College Diabetes Network (CDN), this new name reflects a commitment to expand support to the larger young adult diabetes community, whatever the type of diabetes they live with and whether they're in school or in the workforce.

Currently, there are 3 million young adults (ages 17-30) living with diabetes in the U.S.

The Diabetes Link offers peer support, leadership development, and expert, age-relevant resources tailored specifically to the dynamics of emerging adulthood. In addition to growing their flagship campus network, The Diabetes Link is launching a new online resource hub that will offer 24/7 access to first-hand peer experiences and perspectives, as well as information reviewed and endorsed by clinical experts.

Christina Roth, CEO & Founder, states, "We will stay true to our roots in type 1 diabetes, but the insights we've gained over these last 12 years will also benefit those with Type 2 and other types of diabetes. These young people make over 180 life-altering decisions a day, and they deserve access to support that will help them manage their diabetes AND enjoy the exhilaration of young adulthood. We are here to guide them."

"As the father of a son with type 1 diabetes who just started college, I joined the board of directors to ensure that my son and all teens and young adults like him have the support and information they need to safely and successfully navigate this stage of life" says Brad Stadler, Chair of The Diabetes Link Board of Directors. "It is my privilege to continue advancing this goal while ensuring that all young adults, regardless of where they are in life or in the country, have access to the invaluable resources we have built."

About the Diabetes Link:

The Diabetes Linkis a national 501c3 non-profit organization dedicated to empowering young adults with diabetes by providing access to the peer support, connections, and expert resources they need to thrive. Over the years The Diabetes Link (formerly CDN) has been recognized as the preeminent organization serving young adults with diabetes, establishing national partnerships with organizations such as ADA, JDRF, and the Association for Diabetes Care and Education Specialists (ADCES); also, as the leading provider of young adult patient education by healthcare providers and certification boards such as The Certification Board for Diabetes Care and Education (CBDCE).

For more information, please contact:Alyssa Sullivan 617-899-8631 [emailprotected]

SOURCE The Diabetes Link

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THE DIABETES LINK LAUNCHES TO HELP YOUNG ADULTS THRIVE WHILE LIVING WITH THE DISEASE - PR Newswire

Bagsvrd, Denmark, 3 October 2022 Novo Nordisk today announced headline results from the ONWARDS 5 phase 3a trial with once-weekly insulin icodec in people with type 2 diabetes.

The ONWARDS 5 trial was a 52-week, open-label efficacy and safety treat-to-target trial investigating once-weekly insulin versus once-daily basal insulin (insulin degludec or insulin glargine U100/U300) in 1,085 insulin-nave people with type 2 diabetes in a clinical practice setting including fewer trial visits compared to the other ONWARDS phase 3a trials. Once-weekly insulin icodec was used in combination with a dosing guide app to guide titration.

The trial achieved its primary endpoint of demonstrating non-inferiority in reducing HbA1c at week 52 with insulin icodec compared with once-daily basal insulin analogues. From an overall baseline HbA1c of 8.9%, once-weekly insulin icodec achieved a superior reduction in estimated HbA1c of 1.68%-points compared with 1.31%-points for the once-daily basal insulins (estimated treatment difference: 0.38%-points).

In the trial, there was no statistically significant difference in estimated rates of severe or clinically significant hypoglycaemia (blood glucose below 3 mmol/L) with 0.19 events per patient-year exposed to once-weekly insulin icodec and 0.14 events per patient-year exposed to the once-daily basal insulins. In the trial, once-weekly insulin icodec appeared to have a safe and well-tolerated profile.

We are very pleased to share the positive results from the ONWARDS 5 trial. These results include real-world elements and a dosing guide app, which help us better understand how insulin icodec can make a difference for patients in a clinical practice setting, said Martin Holst Lange, executive vice president for Development at Novo Nordisk. Todays results confirm the results from the previous reported ONWARDS trials and highlight that insulin icodec has the potential to be an ideal insulin for people with type 2 diabetes. We now look forward to sharing the results with regulatory authorities.

Novo Nordisk expects to file for regulatory approval of once-weekly insulin icodec in the US, the EU and China in the first half of 2023.

About the ONWARDS clinical development programme The ONWARDS programme for once-weekly insulin icodec currently comprises six phase 3a global clinical trials, including a trial with real-world elements, involving more than 4,000 adults with type 1 or type 2 diabetes.

ONWARDS 1 is a 78-week trial comparing the efficacy and safety of once-weekly insulin icodec with once-daily insulin glargine U100 both in combination with non-insulin anti-diabetic treatment in 984 insulin-nave people with type 2 diabetes. Following the completion of the main phase of the trial, a 26-week extension phase is ongoing. The results of the main phase were reported on 3 June 2022.

ONWARDS 2 was a phase 3a, 26-week efficacy and safety treat-to-target trial investigating once-weekly insulin icodec vs insulin degludec in 526 people with type 2 diabetes switching from a once-daily insulin. Results were reported on 28 April 2022.

ONWARDS 3 was a 26-week trial comparing once-weekly insulin icodec with once-daily insulin degludec. The objective of the trial was to assess the efficacy and safety of insulin icodec in 588 insulin-nave people with type 2 diabetes. Results were reported on 29 July 2022.

ONWARDS 4 was a 26-week trial comparing once-weekly insulin icodec with once-daily insulin glargine, both in combination with mealtime insulin. The objective of the trial was to assess the efficacy and safety of insulin icodec in 582 people with type 2 diabetes treated with basal and bolus insulin. Results were reported on 29 July 2022.

ONWARDS 5 was a 52-week trial comparing once-weekly insulin icodec with once-daily basal insulin (insulin degludec and insulin glargine U100 and U300) The objective of the trial was to assess the effectiveness and safety of insulin icodec, with an app providing dosing recommendation, in 1,085 insulin-nave people with type 2 diabetes in a clinical practice setting including no upper limit at HbA1c at time of inclusion, no limitations on use of oral antidiabetic treatments and fewer planned site visits compared to the other ONWARDS phase 3a trials (every third month in accordance with recommended clinical practice)

ONWARDS 6 is a 52-week trial comparing once-weekly insulin icodec with once-daily insulin degludec, both in combination with mealtime insulin. The objective of the trial is to assess the efficacy and safety of insulin icodec in 583 people with type 1 diabetes. Following the completion of the main phase of the trial, a 26-week extension phase is ongoing. The results of the main phase were reported on 3 June 2022.

About Novo Nordisk Novo Nordisk is a leading global healthcare company, founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat diabetes and other serious chronic diseases such as obesity and rare blood and endocrine disorders. We do so by pioneering scientific breakthroughs, expanding access to our medicines, and working to prevent and ultimately cure disease. Novo Nordisk employs about 50,800 people in 80 countries and markets its products in around 170 countries. Novo Nordisks B shares are listed on Nasdaq Copenhagen (Novo-B). Its ADRs are listed on the New York Stock Exchange (NVO). For more information, visit novonordisk.com, Facebook, Twitter, LinkedIn and YouTube.

Further information

Company announcement No 73 / 2022

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Once-weekly insulin icodec demonstrates superior reduction in HbA1c in combination with a dosing guide app versus once-daily basal insulin in people...