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The international trial called BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabe-tes) involved 2368 type 2 diabetics with coronary artery disease (70% males), randomly undergoing coronary revascularization or medical therapy for CAD, and randomized also to diabetes treatment: in-sulin stimulation (insulin or sulfonylurea) or insulin sensitization (metformin or rosiglitazone).
MedNews (Diabetology) - Fri, 11 December 2009
http://mn.medsurfnews.com/
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In a recent review by Geer and Shen (1), using the PubMed database and the references cited in these reports, men were reported to have more lean mass and women to have higher adiposity. Men were also found to have more visceral and hepatic adipose tissue, whereas women had more peripheral or subcutaneous adipose tissue. The researchers concluded that these differences, as well as differences in sex hormones and adipokines, may contribute to a more insulin-sensitive environment in women than in men. When they normalized to kilograms of lean body mass, men and women had similar resting energy expenditure, but physical energy expenditure was more closely related to percent body fat in men than in women.
Diabetes Care (Diabetology) - Fri, 11 December 2009
http://care.diabetesjournals.org/
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Metabolically normal obese individuals are not any safer from excess all-cause mortality risks than their peers who are metabolically abnormal, new research in Diabetes Care shows.
Medscape (Diabetology) - Fri, 11 December 2009
http://www.medscape.com
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Diabetic foot osteomyelitis is invariably accompanied by foot ulceration
Plain radiography should be the first imaging test used but may not show changes for up to two weeks
Magnetic resonance imaging is the most accurate imaging modality
Nuclear medicine scans play only a modest role in the diagnosis
Bone biopsy is the criterion standard for the diagnosis of osteomyelitis but is not needed in every case
British Medical Journal (Diabetology) - Fri, 4 December 2009
http://www.bmjjournals.com
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According to three wide trials (ACCORD, ADVANCE and VADT), the intensive control of type 2 diabetes leads to no decrease in cardiovascular risk and in early death; on the contrary, according to the ACCORD trial, the aggressive treatment of diabetes is associated with an increased mortality. Now, some English researchers have published in The Lancet the results of a meta-analysis of 5 randomized trials, also including the three above mentioned ones, verifying, out of more than 33,000 diabetic patients, whether therapeutical aggression of the disease really implies an increase in mortality and in cardiovascular risk in general.
MedNews (Diabetology) - Fri, 4 December 2009
http://mn.medsurfnews.com/
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In the FIELD trial, whose results were published in 2006, about 10,000 type 2 diabetics not taking a lipid-lowering drug (the values of total cholesterol ranged from 116 to 250 mg/dl and the levels of triglycerides from 90 to 440 mg/dl) were randomized to receive 200 mg/die of fenofibrate or placebo. The trial lasted 5 years and the primary outcome (myocardial infarction or death for cardiovascular cause) didn’t result different between the two groups; but it was observed that in the patients treated with fenofibrate there has been a lower progression in albuminuria and a lower use of retinal treatments.
MedNews (Diabetology) - Fri, 4 December 2009
http://mn.medsurfnews.com/
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A previously fit and well 84 year old woman presented with a three month history of worsening double vision. Her double vision was maximal on looking to the left and upwards. Her relatives had also noted "drooping" of her eyelids, which was worse on the right and most noticeable in the evenings. Three weeks previously her upper arms had become progressively weaker, to the extent that she was unable to lift her left hand above her head. The weakness was worse on exertion and improved after rest. Figures 1 and 2 show the patient attempting to look to the left. Her cognitive function and tendon reflexes were normal, and she had no sensory signs.
British Medical Journal (Diabetology) - Fri, 27 November 2009
http://www.bmjjournals.com
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rom many previous trials, we know that modifications in lifestyle and pharmacological interventions are capable to prevent the progression from simple impaired glucose tolerance to real type 2 diabetes, but we also know that changes in lifestyle are difficult to perform and are less quantifiable than drug administration. With a trial sponsored by pharmaceutical industry, performed in Japan, voglibose, an oral alpha-glucosidase inhibitor similar to acarbose, was evaluated.
MedNews (Diabetology) - Tue, 24 November 2009
http://mn.medsurfnews.com/
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Plagemann et al. (3) have previously suggested that the beneficial effects of breast-feeding on childhood obesity are lost when mothers are affected by diabetes. The authors have advised caution with respect to encouraging breast-feeding in mothers with diabetes.
Diabetes Care (Diabetology) - Tue, 24 November 2009
http://care.diabetesjournals.org/
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In a recent study by Liu et al., the complex mechanisms of diabetic foot ulcers were further elucidated. In a series of 62 ulcers, the authors report that they found—for the first time—a positive correlation between a high matrix metalloproteinase-9 (MMP-9)–to–tissue inhibitor of metalloproteinase-1 (TIMP-1) ratio and poor wound healing.
Diabetes Care (Diabetology) - Tue, 24 November 2009
http://care.diabetesjournals.org/