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Diabetes News Roundup: New Thoughts on Standard Thinking
Find research on diabetes patients that could shift your thinking on home blood glucose monitoring; metformin efficacy in T1DM; and race and A1c.
New research into both T2DM and T1DM includes sudies on: ⺠Value of routine glucose self-monitoring in T2DM management in patients who do not take insulin ⺠Impact of metformin in patients with T1DM on weight, LDL-C, and development of atherosclerosis--but what about glycemic control?  ⺠Accuracy of A1c to estimate average glucose levels in blacks compared with whites.Click through our slide show of brief summaries above. References Type 2 DM Patients May Not Need Routine Home Blood Glucose Monitoring. Young LA, et al. Glucose Self-monitoring in NonâInsulin-Treated Patients With Type 2 Diabetes in Primary Care Settings. JAMA Intern Med. Published online June 10, 2017. doi:10.1001/jamainternmed.2017.1233Cardiovascular and Metabolic Effects of Metformin in Type 1 Diabetes. Petrie JR, et al. Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. Published June 11 2017 DOI: http://dx.doi.org/10.1016/S2213-8587(17)30194-8Racial Differences in Hemoglobin A1c Levels. Bergenstal RM, et al. Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels. Ann Intern Med. 2017. DOI: 10.7326/M16-2596
Diabetes News Roundup for July 2017: New thoughts on standard thinking
Type 2 DM Patients May Not Need Routine Home Blood Glucose Monitoring.
Routine self-monitoring of blood glucose levels
does not significantly improve hemoglobin A1c (A1c) levels or health-related quality of life for most patients with nonâinsulin-treated T2DM.
Clinical Implications:
Clinicians should consider the specifics of each patient’s clinical situation when deciding whether to test or not to test for blood glucose levels and whether the costs, including disposable glucose testing strips, outweigh the benefits.
Cardiovascular and Metabolic Effects of Metformin in Type 1 Diabetes
The use of metformin in T1DM
does not significantly reduce insulin requirements and improve glycemia, but can reduce body weight in those with increased BMI and insulin resistance, and appears to have metabolic effects.
Clinical Implications:
Metformin may not improve glycemic control in adults with long-standing T1DM, as suggested by current guidelines, but it appears to have a wider role in cardiovascular risk management.
Racial Differences in Hemoglobin A1c Levels
A1c levels overestimate the mean glucose concentration
in blacks as compared with whites, possibly owing to racial differences in the glycation of hemoglobin.
Clinical Implication:
Race only partially explains the differences in HbA1c between blacks and whites. Future research needs to focus on identifying and modifying barriers impeding improved glycemic control in blacks with diabetes.