Diabetic medicine : a journal of the British Diabetic Association
-
Randomized Controlled Trial Multicenter Study
Linagliptin improved glycaemic control without weight gain or hypoglycaemia in patients with type 2 diabetes inadequately controlled by a combination of metformin and pioglitazone: a 24-week randomized, double-blind study.
To investigate the efficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin in patients with Type 2 diabetes mellitus inadequately controlled by a combination of metformin and pioglitazone. ⋯ Linagliptin as add-on therapy to metformin and pioglitazone produced significant and clinically meaningful improvements in glycaemic control, without an additional risk of hypoglycaemia or weight gain (Clinical Trials Registry No: NCT 00996658).
-
Multicenter Study Observational Study
Does higher quality of primary healthcare reduce hospital admissions for diabetes complications? A national observational study.
To determine if hospital admission rates for diabetes complications (acute complications, chronic complications, no complications and hypoglycaemia) were associated with primary care diabetes management. ⋯ After controlling for population factors, better scheduled primary care access and glycaemic control were associated with lower hospital admission rates across most complications. There is little rationale to restrict primary care-sensitive condition definitions to acute complications. They should be revised to improve the usefulness of hospital admission data as an outcome measure, and to facilitate international comparisons. The risk of emergency hospital admission should be monitored routinely.
-
Multicenter Study
HLA class II gene associations in African American type 1 diabetes reveal a protective HLA-DRB1*03 haplotype.
Owing to strong linkage disequilibrium between markers, pinpointing disease associations within genetic regions is difficult in European ancestral populations, most notably the very strong association of the HLA-DRB1*03-DQA1*05:01-DQB1*02:01 haplotype with Type 1 diabetes risk, which is assumed to be because of a combination of HLA-DRB1 and HLA-DQB1. In contrast, populations of African ancestry have greater haplotype diversity, offering the possibility of narrowing down regions and strengthening support for a particular gene in a region being causal. We aimed to study the human leukocyte antigen (HLA) region in African American Type 1 diabetes. ⋯ The unique diversity of the African HLA region we have uncovered supports a specific and major role for HLA-DRB1 in HLA-DRB1*03 haplotype-associated Type 1 diabetes risk.
-
Multicenter Study
Haemoglobin A(1c) , acute hyperglycaemia and short-term prognosis in patients without diabetes following acute ST-segment elevation myocardial infarction.
To assess the prognostic impact of HbA(1c) and blood glucose level in patients with acute ST-segment elevation myocardial infarction and without diabetes. The relationship between HbA(1c) and acute hyperglycaemia was also explored. ⋯ Unlike acute hyperglycaemia, an elevated HbA(1c) level was not a risk factor for short-term outcomes in ST-segment elevation myocardial infarction patients without diabetes. Patients with acute hyperglycaemia and non-elevated HbA(1c) were associated with the worst prognosis. That suggests chronic glycaemic control/HbA(1c) level may help to recognize stress-induced hyperglycaemia and identify high-risk patients.
-
Multicenter Study
Ramadan Prospective Diabetes Study: the role of drug dosage and timing alteration, active glucose monitoring and patient education.
To observe the effects of active glucose monitoring, alteration of drug dosage and timing, dietary counselling and patient education in the occurrence of acute diabetic complications in fasting individuals with diabetes during the month of Ramadan. ⋯ We observed that, with active glucose monitoring, alteration of drug dosage and timing, dietary counselling and patient education, the majority of the patients did not have any serious acute complications of diabetes during Ramadan.