This article features the top 5 stories in Endocrinology Network's coverage of diabetes management in 2020.
As part of our Year in Review series, Endocrinology Network’s editorial staff has put together a curated list made up of the most viewed and clinically impactful stories from various fields in endocrinology.
While 2020 has been a year where headlines were dominated by coronavirus disease 2019 (COVID-19), the tireless work of clinicians and researchers allowed the field of diabetes care to continue to move forward. Here is our list of the top 5 diabetes stories on Endocrinology Network from 2020.
The theme of 2020’s World Diabetes Day was “The Nurse and Diabetes”. With the number of patients with diabetes ballooning in recent years, there has been more stress than ever placed on endocrinologists. The role of the nurse in many fields has changed and this may be no more evident than in diabetes management. To learn more about this evolution and the role of nurses in diabetes care, we reached out to Lucia Novak, CRNP, Capital Diabetes and Endocrine Associates.
In the last decade, there was been an unprecedented wave of research dedicated to learning about the cardio and renal protective benefits of antidiabetes medications and that continued in 2020. While much of the spotlight was still on SGLT2 inhibitors and GLP-1 RAs, finerenone demonstrated its value in treatment regimens with the results of the FIDELIO-DKD trial in October 2020.
Presented at the American Society of Nephrology's Kidney Week 2020, results of the phase 3 trial suggest the non-steroidal, selective mineralocorticoid receptor agonist from Bayer lowered risk of CKD progression by 18% while also providing a 16% in the study's cardiovascular outcome in a population of more than 5500 diabetic patients.
A revolution in care in its own right, the knowledge base surrounding the effects of oral semaglutide (Rybelsus) continued to expand during the past year. Among the multitude of analyses and studies examining the first oral GLP-1 RA ever approved for treatment of diabetes was a pooled analysis assessing impact of background glucose-lowering therapies on the effects of oral semaglutide presented by John Buse, MD, at ADA 2020.
An analysis of 5 studies from within the PIONEER program, results indicated the effects of oral semaglutide on weight management and HbA1c reductions regardless of background glucose-lowering therapy. Background therapies examined in the study included metformin, sulfonylurea, SGLT2 inhibitors, insulin, or combinations of the aforementioned therapies.
As it stands, endocrinologists are in short supply, they treat dozens of conditions, and the number of patients with diabetes is growing. Just based on this alone, some would suggest an intervention, such as the creation of a new subspecialty, is already overdue. However, many endocrinologists would argue they are still the best equipped to treat these patients and arguing for the creation of a cardiometabolic subspecialty only detracts from endocrinology as a field.
While smaller than most other trials featured on Endocrinology Network, this 16-person trial presented at UEG Week 2020 suggests a minimally-invasive, outpatient procedure combined with GLP-1 RA therapy could dramatically improve glucose control in patients with type 2 diabetes.
Conducted by investigators at the Amsterdam University Medical Center, the trial examined the effect of duodenal mucosal resurfacing (DMR) ablation and subsequent GLP-1 RA. At the 6-month follow-up, 12 of 16 were free from insulin therapy and had an HbA1c of 7.5% or less. At 12 months, 9 patients remained free from insulin had a median HbA1c of 6.7%.