Endodiabesity

The North West of England Endocrinology, Diabetes and Obesity Newsletter

Archive for the ‘Studies’ Category

Semaglutide and CV Outcomes

Posted by Akheel Syed on 12 November, 2016

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375:1834-1844

In patients with type 2 diabetes who were at high cardiovascular risk, the rate of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke was significantly lower among patients receiving semaglutide than among those receiving placebo, an outcome that confirmed the noninferiority of semaglutide.

http://www.nejm.org/doi/full/10.1056/NEJMoa1607141

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Study busts myth of “metabolically healthy” obesity

Posted by Safwaan Adam on 13 December, 2013

This review shows that even in the absence of metabolic complications, obese people are at risk of long-term adverse outcomes.

Published in BMJ 2013;347:f7324 

 

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WHO Atlas on coronary heart disease world wide prevalence – a summary

Posted by Rahul Yadav on 2 December, 2013

 “Misfortunes always come in by a door that has been left open for them.” Czechoslovakian proverb

The World Health Organization’s Atlas for Heart Disease and Stroke illustrates that globally in 2002 coronary heart disease (CHD) accounted for 6.8% and 5.3% of Disability Adjusted Life Years (DALYs) in men and women respectively. DALYs are the same as years of life lost to disability and death, and therefore suggest a more meaningful way of projecting disease burden as opposed to simply the resulting death. The burden of CHD is expected to rise from 47 million DALYs in 1990 to 82 million DALYs in 2020 [1]. These figures are similar to HIV/AIDS and unipolar depressive disorders. CHD is now the leading cause of death worldwide and knows no borders. 3.8 million men and 3.6 million women die from CHD each year [2].

The basis of CHD is regarded to be atherosclerosis. Hypercholesterolemia is a major contributor to atherosclerosis. The incidence of CHD is much lower in rural China and Japan where average plasma cholesterol concentration is 4.0 mmol/l as compared to the United Kingdom where it is 5.9 mmol/l and CHD is a major cause of death [3].

1.            WHO. Global burden of coronary heart disease. Cardiovascular Disease, The Atlas of Heart Disease and Stroke  2011 2011 [cited 2011; Available from: http://www.who.int/cardiovascular_diseases/en/cvd_atlas_13_coronaryHD.pdf.

2.            WHO. Deaths from coronary heart disease. Cardiovascular Disease, The Atlas of Heart Disease and Stroke  2011  [cited 2011; Available from: http://www.who.int/cardiovascular_diseases/en/cvd_atlas_14_deathHD.pdf.

3.            Chaudhury M, Chapter 9. Risk factors for cardiovascular disease. Health Survey for England 2003, ed. Sproston K. Vol. 2. 2004, London: The Stationary Office.

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BMJ Meta-analysis on Bariatric Surgery Outcomes

Posted by Safwaan Adam on 8 November, 2013

Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials

This is a review article highlighting improvement in metabolic parameters post bariatric surgery compared to non-surgical weight loss.

BMJ 2013;347:f5934

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Recent articles of interest

Posted by Akheel Syed on 27 April, 2012

Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes. N Engl J Med 2012; 366:1567-1576

Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes. N Engl J Med 2012; 366:1577-1585

Acute headache and visual field defect. BMJ 2012;344:e2229

Diagnosis and management of primary hyperparathyroidism. BMJ 2012;344:e1013

Out-of-Hospital Administration of Intravenous Glucose-Insulin-Potassium in Patients With Suspected Acute Coronary Syndromes. JAMA 2012; doi: 10.1001/jama.2012.426

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Metformin and insulin versus insulin alone for type 2 diabetes

Posted by Akheel Syed on 20 April, 2012

BMJ 2012;344:e1771

“The researchers say the combination leads to better blood sugar control, less weight gain and less need for insulin. However, they also suggest that more trials are needed to provide firm evidence about the long term benefits and harms of the combination and specifically about the risks of premature death.” – BMJ Press Release

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DKA at diagnosis of diabetes

Posted by Akheel Syed on 8 July, 2011

Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults

In this systematic review, Usher-Smith and colleagues looked at 46 studies of more than 24 000 children from 31 countries. They found that multiple factors affect the risk of developing diabetic ketoacidosis at the onset of type 1 diabetes in children and young adults, and there is potential time, scope, and opportunity to intervene between symptom onset and development of diabetic ketoacidosis for both parents and clinicians. In a linked editorial, Sasigarn A Bowden says that the findings from this study should heighten the awareness of clinicians caring for children and adolescents and continuing education should be provided on the presentation of diabetes.” – bmj.com

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White rice or brown rice?

Posted by Akheel Syed on 16 June, 2010

White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women
Qi Sun, MD, ScD; Donna Spiegelman, ScD; Rob M. van Dam, PhD; Michelle D. Holmes, MD, DrPH; Vasanti S. Malik, MSc; Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD
Arch Intern Med. 2010;170(11):961-969

In this large scale epidemiological study of diet, lifestyle practices, and disease status among 39 765 men and 157 463 women, higher intake of white rice (> 4 servings per week vs < 1 per month) was associated with a higher risk of type 2 diabetes: pooled relative risk 1.17 (95% confidence interval 1.02 to 1.36).

The authors conclude with the recommendation that most carbohydrate intake should come from whole grains rather than refined grains to help prevent type 2 diabetes.

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Diurnal variation of testosterone in practice

Posted by Seleena Farook on 26 July, 2009

http://jcem.endojournals.org/cgi/content/abstract/94/3/907

It is a good idea to ask for 9am testosterone levels to avoid overdiagnosis of hypogonadism.

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Thyroid function tests in the elderly on thyroxine

Posted by Seleena Farook on 25 July, 2009

http://jcem.endojournals.org/cgi/content/abstract/94/4/1342

Regular thyroid function testing could easily be forgotten in this group.

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