Canagliflozin as primary CVD prevention in people with diabetes and CKD

Adding the SGLT2 inhibitor canagliflozin to standard care for people with type 2 diabetes (T2D) who have chronic kidney disease reduces both kidney failure and cardiovascular events in people with no history of cardiovascular disease, the CREDENCE trial has shown.
The trial randomised 4,401 people with …

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How to increase physical activity in everyday life

There is no single solution to the problem of increasing physical activity as part of everyday life but Moving Matters, a report by the National Institute for Health Research, identifies several effective interventions based on its review of published evidence.
It recommends that community organisations and …

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SGLT2 inhibitors recommended for more indications

NICE has given the nod to combining dapagliflozin with insulin for people with type 1 diabetes (T1D) provided they meet several criteria (https://www.nice.org.uk/guidance/gid-ta10374/documents/html-content-2). Its final appraisal document – which will be published as technology appraisal guidance in August, subject to consultation – recommends combined therapy …

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Freestyle Libre improves T1D control and cuts admissions

The flash monitoring device Freestyle Libre improved glycaemic control in 80% of users and cut hospital admissions for hyperglycaemia by almost three-quarters, an audit by the Association of British Clinical Diabetologists.
The audit, presented at the American Diabetes Association’s 79th Scientific Session in June, compared data …

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People with non-diabetic hyperglycaemia broadly similar to those with type 2 diabetes

The characteristics of the population in England with non-diabetic hyperglycaemia (NDH; HbA1c 42 – 47 mmol/mol or fasting plasma glucose 5.5 – 6.9 mmol/l) are broadly similar to those of people with type 2 diabetes (T2D), data from the NHS Diabetes Prevention Programme (DPP) shows.
The …

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Diabetes treatment during Ramadan

In 2019, Ramadan runs from May 5th until June 4th and many people with diabetes will want to share the event with their families by fasting. Dr Waqas Tahir, GP and Clinical Lead at the Bradford Care Alliance, has prepared a handy guide for health …

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Real-world evidence on semaglutide

The Association of British Clinical Diabetologists (https://abcd.care) has developed an online tool for auditing real-world use of the GLP-1 receptor agonist semaglutide to help determine whether the results of clinical trials can be matched in daily practice.
A previous audit by ABCD showed that GLP-1 receptor …

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Chinese herbal medicine may improve renal function

Chinese herbal medicine may improve renal function and reduce albuminuria in adults with diabetic kidney disease, regardless of the use of ACE inhibitors or angiotensin receptor blockers (ACEis/ARBs), according to researchers in China and Australia (BMJ Open 2019;9:e025653. doi: 10.1136/bmjopen-2018-025653).
Their meta-analysis of 20 randomised trials …

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Liraglutide in children and young people

Liraglutide, currently licensed in the UK only for adults, improves glycaemic control in 10 – 17 year-olds with poorly controlled type 2 diabetes despite treatment with metformin +/- basal insulin (NEJM 2019; DOI: 10.1056/NEJMoa1903822).
The double blind ELLIPSE trial randomised 134 patients (mean age 14.6) to …

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Developments with SGLT2 inhibitors

More evidence to show that empagliflozin lowers blood pressure in people with type 2 diabetes and hypertension was recently published.
In patients of African Caribbean origin with mean baseline blood pressure of 146/89 mmHg, empagliflozin lowered systolic pressure by 5.2 mmHg after 6 months and by …

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