The American Diabetes Association's 70th Scientific Sessions took place June 25 to 29 in Orlando, Fla., and attracted about 13,500 professional attendees from around the world to share cutting-edge research, treatment recommendations, and advances toward a cure for diabetes.
"Some of the bigger themes included release of the final ACCORD (Action to Control Cardiovascular Risk in Diabetes) results, and late-breaking clinical trials, many of which focused on where we stand in terms of the impact of diabetes on cardiovascular disease and mortality," said David Kendall, M.D., chief scientific and medical officer for the American Diabetes Association. "Another important theme was improved understanding of the ever-greater potential impact of hypoglycemia, and ways we hope to limit its risk and recurrence."
The ACCORD results confirmed that neither more intensive lowering of blood pressure, more intensive lowering of blood glucose, nor treatment of blood lipids with a fibrate and a statin drug is associated with a decreased cardiovascular risk in patients with type 2 diabetes who are at extremely high risk for cardiovascular events. However, researchers also observed improvements in microvascular conditions such as progression of diabetic retinopathy, visual acuity, and renal and nerve function.
"These results underscore the importance of patient-centered care that stresses individual treatment choices made in consultation with a physician," Denise Simons-Morton, M.D., director of the Division for the Application of Research Discoveries at the National Institutes of Health's National Heart, Lung and Blood Institute, said in a statement. "Within this group, it's important for patients and doctors to decide the highest priority for the patient."
Other meeting highlights included the Healthy Living Partnerships to Prevent Diabetes (HELP PD) study, which showed that a community-based diabetes prevention program helps people lose weight and lower blood sugar as effectively as individual counseling by health professionals.
During the study, researchers assigned one group of participants to a lifestyle intervention group, which included six months of weekly group behavioral weight loss sessions run by lay community health workers, which was followed by monthly meetings encouraging them to improve their eating habits and exercise up to 180 minutes per week. They assigned a second group of participants to a usual-care group, which received two visits with a dietitian and a quarterly newsletter with tips for lifestyle changes.
Compared to the usual-care group, the researchers found that the intervention group had lost significantly more body weight (an average of 7.3 percent versus an average of 1.3 percent) after 12 months. They also found that the intervention group reduced blood glucose levels by an average of more than 4 mg/dL (from 105.8 mg/dL to 101.2 mg/dL), while the usual-care group reduced levels by less than 2 mg/dL (to 104 mg/dL) after 12 months. They concluded that the results were similar to those achieved over a three-year period by participants in the landmark National Institutes of Health-sponsored Diabetes Prevention Program.
"In the Diabetes Prevention Program, professional behavioral specialists worked with participants with pre-diabetes in one-on-one sessions," HELP PD lead researcher, David Goff, M.D., of the Wake Forest University School of Medicine in Winston-Salem, N.C., said in a statement. "We trained some of our patients with diabetes to work as lay community health workers with groups of participants with pre-diabetes, so we really didn't expect to see quite as good a weight loss result as we did, but we were very pleased to see it. Given that our weight loss results look as good as the Diabetes Prevention Program, this approach shows great promise for preventing diabetes. It's a very translatable intervention to deliver in public health settings. We think this approach could be replicated at Diabetes Care Centers across the country."
A study led by researchers from the University of Pittsburgh Graduate School of Public Health suggested that increased intake of omega-3 fatty acids does not improve cardiovascular disease risk in women with long-standing type 1 diabetes.
The researchers assessed outcomes in 601 men and women who were diagnosed with type 1 diabetes between 1950 and 1980, including 166 (27.6 percent) who were diagnosed with cardiovascular disease. Although consumption of more than 0.2 g of omega-3 fatty acids was associated with a lower incidence of cardiovascular disease in men, no such benefits were observed in women.
"Although omega-3 is typically associated with decreased risk for cardiovascular disease, this may not be the case for women who have type 1 diabetes," lead author, Tina Costacou, Ph.D., said in a statement. "Importantly, our study suggests we shouldn't assume men and women with type 1 diabetes are the same."
Another study from the University of Pittsburgh Graduate School of Public Health suggested that death rates from type 1 diabetes are steadily improving but that there are still substantial gender and racial disparities.
During the study, researchers followed about 1,100 patients who were diagnosed between 1965 and 1979, 26 percent of whom had died by January 2008. Compared to death rates in matched subjects in the general population, they found that death rates were seven times higher in the patients overall, but only 5.5 times higher in patients diagnosed between 1975 and 1979.
Compared to the general population, they also found that death rates were higher in women with type 1 diabetes than in men with the disease (13 times higher than the general population versus five times higher). In addition, they found that 30-year survival was lower in African-American patients than in white patients (52 versus 82 percent).
"The more recent a person was diagnosed with type 1 diabetes, the less likely they were to die, suggesting the positive impact of advances made during the last few decades," lead author, Aaron M. Secrest, said in a statement. "Even so, significant disparities in mortality remain and reveal a need for continuing improvements in diabetes treatment and care."
ADA: Intensive Therapy Helps in Some Diabetes Outcomes
TUESDAY, June 29 (HealthDay News) -- In patients with established type 2 diabetes, intensive glucose-lowering therapy improves some outcomes but is also associated with increased mortality, weight gain, and an increased risk of severe hypoglycemia, according to a study published online June 29 in The Lancet to coincide with presentation at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla.
ADA: Sensor-Augmented Pump Effective in Type 1 Diabetes
TUESDAY, June 29 (HealthDay News) -- Adults and children with suboptimal control of type 1 diabetes may achieve significant improvement in glycated hemoglobin levels with the use of a sensor-augmented insulin pump compared to a regimen of multiple daily injections of recombinant insulin analogues, according to a study published online June 29 in the New England Journal of Medicine to coincide with presentation at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla.
ADA: Rosiglitazone Not Linked to Adverse Cardio Outcomes
TUESDAY, June 29 (HealthDay News) -- In contrast to other recently published research, a new study presented June 29 at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla., suggests that rosiglitazone may not increase the risk of death, stroke, or heart attack -- though it does increase fracture risk -- in patients with type 2 diabetes and established cardiovascular disease.
ADA: Diabetes Risk Reduction Program Has Mixed Results
MONDAY, June 28 (HealthDay News) -- A school-based intervention addressing the increased risk of obesity and type 2 diabetes in particular ethnic and socioeconomic groups did not result in greater decreases in the rate of overweight and obesity than at schools not performing an intervention, but it may be associated with significant decreases in other indexes of adiposity, according to a study published online June 27 in the New England Journal of Medicine to coincide with presentation at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla.
ADA: Artificial Pancreas Advances Highlighted
MONDAY, June 28 (HealthDay News) -- In individuals with type 1 diabetes, artificial pancreas technology may significantly improve overnight blood sugar control without increasing the risk for hypoglycemia, though certain psychosocial barriers may prevent successful use of a continuous glucose monitoring (CGM) system, an important artificial pancreas component, according to speakers at a joint American Diabetes Association -- Juvenile Diabetes Research Foundation (JDRF) symposium held June 27 at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla.
ADA: Exenatide Bests Insulin As Second-Line Therapy
MONDAY, June 28 (HealthDay News) -- In patients with type 2 diabetes who have inadequate glycemic control despite treatment with maximum tolerated doses of first-line blood-glucose lowering drugs for three months or longer, a once-weekly injection of exenatide may be associated with better glycemic control and greater weight loss than daily injections of insulin glargine, according to a study published in the June 26 American Diabetes Association meeting Special Issue of The Lancet.
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ADA: Antioxidants Don't Reduce Preeclampsia Risk
MONDAY, June 28 (HealthDay News) -- In pregnant women with type 1 diabetes, supplementation with vitamins C and E does not reduce the risk of preeclampsia, though vitamin supplementation might benefit women with a low antioxidant status at baseline, according to research published online June 26 in The Lancet to coincide with presentation at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla.
ADA: Combo Therapy Helpful in Metformin-Resistant Diabetes
FRIDAY, June 25 (HealthDay News) -- In patients with type 2 diabetes who do not respond adequately to metformin alone, the addition of the drug dapagliflozin -- a selective sodium-glucose cotransporter-2 (SGLT2) inhibitor that acts without affecting insulin-dependent systems -- may be an effective treatment option, according to research published in the June 26 American Diabetes Association meeting Special Issue of The Lancet.
ADA: Diabetes Doubles Risk of Several Vascular Diseases
FRIDAY, June 25 (HealthDay News) -- Diabetes independently doubles the risk of a range of vascular diseases, and may now account for one in every 10 deaths from cardiovascular disease, according to research published in the June 26 American Diabetes Association meeting Special Issue of The Lancet to coincide with presentation at the American Diabetes Association's 70th Scientific Sessions, held from June 25 to 29 in Orlando, Fla.
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