Diabetes Care

http://care.diabetesjournals.org

List of Papers (Total 9,742)

Comment on Cheng et al. Trends and Disparities in Cardiovascular Mortality Among U.S. Adults With and Without Self-Reported Diabetes, 1988–2015. Diabetes Care 2018;41:2306–2315

We read with great interest the recently published article by Cheng et al. (1). The authors note that there was a dramatic increase in prevalence (age-standardized) between the 1980s and 2010 (3% and 9%, respectively) in the population with diabetes compared with the population without, along with a decrease in the excess risk of cardiovascular disease (CVD). The authors...

Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

OBJECTIVE We examined the effects of metformin on diabetes prevention and the subgroups that benefited most over 15 years in the Diabetes Prevention Program (DPP) and its follow-up, the Diabetes Prevention Program Outcomes Study (DPPOS). RESEARCH DESIGN AND METHODS During the DPP (1996–2001), adults at high risk of developing diabetes were randomly assigned to masked placebo ( n...

Home Use of Day-and-Night Hybrid Closed-Loop Insulin Delivery in Very Young Children: A Multicenter, 3-Week, Randomized Trial

OBJECTIVE We aimed to assess the feasibility and safety of hybrid closed-loop insulin delivery in children with type 1 diabetes aged 1–7 years as well as evaluate the role of diluted insulin on glucose control. RESEARCH DESIGN AND METHODS In an open-label, multicenter, multinational, randomized crossover study, 24 children with type 1 diabetes on insulin pump therapy (median age...

More Evidence for a Prevention-Related Indication for Metformin: Let the Arguments Resume!

Global estimates of the number of individuals with diabetes are staggering, and the prevalence is reported to be increasing in most countries. In 2017, it was estimated that approximately 425 million adults (20–79 years of age) were living with diabetes and that half were undiagnosed (1). This number with diabetes is projected to increase to 629 million individuals by 2045 (1...

Comment on Laiteerapong et al. The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study). Diabetes Care 2019;42: 416–426

We read with interest the article from Laiteerapong et al. (1) about the effect of early glycemic control on micro- and macrovascular complications and mortality in individuals with newly diagnosed type 2 diabetes. However, we have major concerns regarding their study. First, we are concerned about the use of conditioning on the future when selecting the study sample, i.e., those...

Material Need Insecurity and Its Concurrent Barriers to Diabetes Management Among Low-Income Latino Adults Receiving Medical Care

Material need insecurity—limited or uncertain ability to access or pay for basic needs such as food, housing, or energy (1)—is reported by 18.9% of older adults with chronic health conditions (2). The association between material need insecurity and health is likely bidirectional (1,3). The sacrifices and trade-offs made to meet material needs lead to exacerbation of chronic...

Impact of Early Diabetic Ketoacidosis on the Developing Brain

OBJECTIVE This study examined whether a history of diabetic ketoacidosis (DKA) is associated with changes in longitudinal cognitive and brain development in young children with type 1 diabetes. RESEARCH DESIGN AND METHODS Cognitive and brain imaging data were analyzed from 144 children with type 1 diabetes, ages 4 to <10 years, who participated in an observational study of the...

Lois Jovanovič, MD, MACE: Pioneer in the Field of Diabetes and Pregnancy and Beyond

Lois Jovanovič is a name that has become synonymous with good pregnancy outcomes for women with type 1 diabetes. Having type 1 diabetes herself and experiencing the challenges it poses for the pregnant woman, Dr. Jovanovič devoted her career to helping women with diabetes prepare for pregnancy and experience successful outcomes. She always emphasized the importance of being in...

2018 Health Care & Education Presidential Address: The American Diabetes Association in the Era of Health Care Transformation

This address was delivered by Felicia Hill-Briggs, PhD, ABPP, President, Health Care & Education of the American Diabetes Association (ADA) at the ADA’s 78th Scientific Sessions in Orlando, FL, on 23 June 2018. Diabetes has become a high-priority condition in the current era of health care transformation due to diabetes and prediabetes prevalence rates, suboptimal diabetes...

Connecting the Dots: Validation of Time in Range Metrics With Microvascular Outcomes

The landmark Diabetes Control and Complications Trial (DCCT) identified the relationship between intensive diabetes management for those with type 1 diabetes (T1D) and a delay in the onset or progression of microvascular complications, shifting the paradigm of clinical care for this chronic medical condition (1). Importantly, the data from that trial continue to have a lasting...

Incidence Rates of Type 2 Diabetes in People With Impaired Fasting Glucose (ADA vs. WHO Criteria) and Impaired Glucose Tolerance: Results From an Older Population (KORA S4/F4/FF4 Study)

The American Diabetes Association (ADA) Expert Committee introduced impaired fasting glucose (IFG: 100–125 mg/dL [5.6–6.9 mmol/L]) as a category with an increased risk for diabetes (1). The World Health Organization (WHO) defined a higher IFG cut point of 110 mg/dL (6.1 mmol/L) because using the lower cut point would substantially increase IFG prevalence and there was no evidence...

Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes

OBJECTIVE Abnormally elevated proinsulin secretion has been reported in type 2 and early type 1 diabetes when significant C-peptide is present. We questioned whether individuals with long-standing type 1 diabetes and low or absent C-peptide secretory capacity retained the ability to make proinsulin. RESEARCH DESIGN AND METHODS C-peptide and proinsulin were measured in fasting and...

Pancreas Volume Declines During the First Year After Diagnosis of Type 1 Diabetes and Exhibits Altered Diffusion at Disease Onset

OBJECTIVE This study investigated the temporal dynamics of pancreas volume and microstructure in children and adolescents with recent-onset type 1 diabetes (T1D) and individuals without diabetes, including a subset expressing autoantibodies associated with the early stages of T1D. RESEARCH DESIGN AND METHODS MRI was performed in individuals with recent-onset stage 3 T1D ( n = 51...

Genetics Coming of Age in Type 1 Diabetes

Decades of studies demonstrate that ∼50% of risk for type 1 diabetes (T1D) is heritable (1). The first loci linked to T1D were the HLA genes that have the largest effect size of any T1D susceptibility locus, followed by linkage of the insulin VNTR to T1D (2,3). Linkage studies have given way to genome-wide association studies (GWAS) that have identified >50 loci that contribute...

Probing the Meaning of Persistent Propeptide Release in Type 1 Diabetes

Type 1 diabetes is well recognized to be immune mediated, resulting in destruction of β-cells. That this eradication is not always complete was evident in an early report from the Diabetes Control and Complications Trial (DCCT) showing that 11% of adult participants with type 1 diabetes for more than 5 years had measurable C-peptide in the fasting state and following mixed-meal...

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HbA1c, Insulin Resistance, and β-Cell Function in Relation to Cognitive Function in Type 2 Diabetes: The CAROLINA Cognition Substudy

Cognitive dysfunction is increasingly recognized as a complication of type 2 diabetes. There is a growing evidence for etiologic roles of glycemia and insulin resistance, although important questions remain (1,2). Elevated levels of glycosylated hemoglobin (HbA1c) appear to be related to worse cognition, but there are indications that the same holds true for lower HbA1c levels...

Variations in Risk of End-Stage Renal Disease and Risk of Mortality in an International Study of Patients With Type 1 Diabetes and Advanced Nephropathy

OBJECTIVE Patients with type 1 diabetes and diabetic nephropathy are targets for intervention to reduce high risk of end-stage renal disease (ESRD) and deaths. This study compares risks of these outcomes in four international cohorts. RESEARCH DESIGN AND METHODS In the 1990s and early 2000s, Caucasian patients with type 1 diabetes with persistent macroalbuminuria in chronic...

Decreasing Cumulative Incidence of End-Stage Renal Disease in Young Patients With Type 1 Diabetes in Sweden: A 38-Year Prospective Nationwide Study

OBJECTIVE Diabetic nephropathy is a serious complication of type 1 diabetes. Recent studies indicate that end-stage renal disease (ESRD) incidence has decreased or that the onset of ESRD has been postponed; therefore, we wanted to analyze the incidence and time trends of ESRD in Sweden. RESEARCH DESIGN AND METHODS In this study, patients with duration of type 1 diabetes >14 years...

Increased Reporting of Immune Checkpoint Inhibitor–Associated Diabetes

Immune checkpoint inhibitors (CPI) have proven remarkably effective in treating many types of malignancies but have been associated with significant risk for immune-related adverse events (irAEs) (1). Among these, new onset of insulin-dependent diabetes mellitus (DM) occurs in 0.2–1.0% of patients (2,3) and is being seen more frequently as CPI become more widely used. However...

Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self...

Evaluation and Management of Youth-Onset Type 2 Diabetes: A Position Statement by the American Diabetes Association

Although all types of diabetes result in hyperglycemia, the pathophysiology of each type of diabetes is different. These guidelines summarize available data specific to the comprehensive care of youth with type 2 diabetes. The objective is to enrich the recognition of type 2 diabetes in youth, its risk factors, its pathophysiology, its management, and the prevention of associated...