Type 1 diabetes and glycemic control

Both type 1 and type 2 diabetes are independently associated with an increased risk for death among hospitalized patients with COVID-19, and a number of factors including poor glycemic control and BMI may predict mortality risk, suggest findings from two studies published in The Lancet Diabetes & Endocrinology.

People with type 1 diabetes treated with multiple daily insulin injections struggle to achieve guideline-recommended targets for time in hypoglycemia while simultaneously reaching their glycated hemoglobin goals, researchers report.

Simon Heller explains why time-in-range targets are so helpful for people with diabetes… yet handing out continuous glucose monitoring devices willy-nilly could do more harm than good.

Researchers report that women’s educational attainment is strongly associated with the glycated hemoglobin levels of their children with type 1 diabetes.

Factors associated with poor glycemic control in children with type 1 diabetes generally vary according to the insulin regimen used, but family conflict over diabetes management universally impacts all insulin users, US researchers report.

The risk for preterm birth among women with type 1 diabetes increases considerably with increasing glycated hemoglobin levels around the time of conception, study findings indicate.

DIY closed-loop insulin delivery has provoked controversy within the diabetes community, raising questions around patient empowerment, safety and liability, and whether the regulatory process remains fit for purpose in a technological age. medwireNews takes a look at the issues.

Lucidi P et al. Curr Diab Rep 2018; 18: 83. doi: 10.1007/s11892-018-1065-6

The Flexible Lifestyles Empowering Change intervention has failed to improve glycated hemoglobin levels in a randomized trial involving adolescents with type 1 diabetes, despite improving some psychosocial outcomes.

Advisory Board member Katharine Barnard scrutinizes the opinion that clinicians should be relying on glycemic outcomes when weighing the decision to prescribe a diabetes device.

Carmen Soto and David Strain provide their insights on clinical inertia in diabetes care and present the co-production model of open communication as an innovative means to address this widespread clinical issue.

People with type 1 diabetes are approximately twice as likely to experience gastrointestinal symptoms as those without, and these symptoms are associated with poor glycemic control and quality of life, study results suggest.

McDonnell ME. Curr Diab Rep 2018; 18: 42. doi: 10.1007/s11892-018-1015-3

Advisory Board member Pamela Dyson underlines the key features for healthcare professionals working in diabetes education, diabetes management, type 2 diabetes prevention, and cardiovascular risk reduction.

The first randomized trial of islet transplantation supports its use in patients with severe, unstable type 1 diabetes.

Zivkovic M, Petrovski G, Bitoska I. Acta Diabetol 2018; Advance online publication. doi: 10.1007/s00592-018-1147-6

A study of type 1 diabetes patients voluntarily following a very-low-carbohydrate diet suggests that the approach could help to achieve excellent control of blood glucose levels.

Diabetes and endocrinology Consultant and Advisory Board member Terence Pang highlights the benefits that a structured approach to glycemic goal setting can bring to your practice and patients with type 1 diabetes.

The excess mortality risk associated with high or very low glycated hemoglobin values is modified by glycemic variability in diabetes patients aged 70 years or more, shows an analysis of The Health Improvement Network database.

As the utility and availability of devices surges, so too do patient expectations. Advisory Board member Katharine Barnard provides key consultation questions to help determine your patients’ greatest needs and obstacles.