[acb-diabetics] many articles

[Patricia LaFrance-Wolf]

1.%% M 6/27 FDA Approves Belviq -First New Weight-Loss Drug in More Than a
Decade Belviq (lorcaserin), was approved for obese adults who have high BP,
high cholesterol or T2. D Katz, Yale said ".. its effects appear to be
modest & there are still concerns about a potential for damage to heart
valves.."The drug works to help suppress appetite by activating an area of
the brain called the serotonin 2C receptor. The weight-loss drugs
fenfluramine & dexfen-fluramine "fen-phen," targeted a different part of the
serotonin system, & were pulled from the market because they boosted the
risk of heart valve damage. [8,000 pts;1yr] Treatment also included diet &
EX. Among the pts with T2, 38% lost at least 5% of their weight vs 16% of
those on the dummy pill. "People need to understand that lifestyle
modifications are essential for successful weight loss, wt maintenance, &
fitness programs. Belviq should be stopped if pts don't lose at least 5% of
their weight within 12 wks, since they're unlikely to benefit from taking
the drug for any longer period of time.

2.%% ADA 6/29 Genetics of Diabetes DM does not seem to be inherited in a
simple pattern. Yet clearly, some people are born more likely to get
diabetes than others. T1 & T2 have different causes. Yet 2 factors are
important in both -- You inherit a predisposition to the disease then
something in your environment triggers it. Genes alone are not enough. When
one Identical twin has T1, the other gets the disease.. only half the time.
When one twin has T2, the other's risk is at most 3 in 4. In most cases of
T1, people need to inherit risk factors from both parents.. T1 is more
common in cold climates. Another trigger might be viruses. Perhaps a virus
that has only mild effects on most people triggers T1 in others. T1 is less
common in people who were breastfed.. In studies of relatives of people with
T1, most of those who later got DM had certain autoantibodies in their blood
for years before. (Antibodies are proteins that destroy bacteria or
viruses). Auto-antibodies are anti-bodies 'gone bad,' which attack the
body's own tissues.) T2DM has a stronger link to family history & lineage
than T1 although it too depends on environmental factors & lifestyle. It may
be difficult to figure out whether your DM is due to lifestyle factors or
genetic susceptibility. Most likely it is due to both.

3.%% ADA 6/28 Anxiety disorder & other psychiatric conditions may be more
likely with diabetics Many are aware that DM is a physical health challenge,
but it turns out that diabetics may also be more likely to struggle with
psychiatric problems. [200pts] neuropsychiatric assessments-21% were
classified as having general anxiety disorder, 24% some type of
depression,2.5% had panic disorder & 2% were considered at "risk of
suicide". How could a blood sugar disorder affect mental health?.. Human
physiology is a balancing act, where energy must be acquired then used or
stored. "Diabetes" is a label for disorders where energy-rich sugars are not
metabolized correctly, resulting in unhealthy high blood glucose levels. The
hormone insulin, secreted from the pancreas causes certain cells to take in
& store BS. Some times not enough insulin is produced to regulate BS or
cells do not properly respond to the insulin signals These situations
correspond to the 2 major categories of DM: T1- pancreas does not make
enough insulin;T2 cells do not process blood insulin correctly. Study
results point to the need for increased appropriate evaluation of pts that
considers mental issues." Comp Psych 4/2012 

4.%% ADA 6/29 Apolipoproteins (apos) Are Biomarkers for Diabetic Retinopathy
-Sasongko & team investigated whether apoAI & apoB levels correlated with
measures of systemic & retinal microvascular function in 224pts "Our
findings may elucidate the role of apos in DR & support previous evidence
that serum apos are stronger bio-markers for DM retinopathy, & possibly
other diabetic microvascular complications, than traditional lipids,"

5.%% M 7/2 Study Supports Intervention in NSTEMI Diabetics A meta- analysis
of nearly 10,000 pts supports early intervention rather than a conservative
approach for non-ST-elevation myocardial infarction (NSTEMI) [type of heart
attack] in diabetics. Invasive strategies reduced nonfatal MI in DM patients
Relative Risk 0.71, but not in non-DM pts RR 0.98 vs conservative
strategies.The absolute risk reduction in MI with an invasive strategy was
greater in diabetics than in nondiabetics 3.7% vs 0.1%) there were no
differences in death or stroke between the groups J AmerCollege Cardiology
7/10/12

6.%% ENDO 2012 Modified Sleeve Gastrectomy Can Treat T2 Dr. K Modi,
presenter advises physicians to consider the surgery at an earlier stage of
T2DM not as a last resort. [43pts] had sleeve gastrec-tomy & an ileal
interposition; [17pts who had DM for +15yrs, had diverted sleeve gastrectomy
+ ileal interposition.] The procedure diverts food from the duodenum. In a
20m f-up there was remission in 20 pts of the first group & 2 of the 2nd
grp. When Dr.M excluded data from pts who were not obese, the remission rate
rose from 47% to 85%. The surgery's effects may be two-fold. The sleeve
restricts calories absorbed & reduces ghrelin ("hunger hormone"), ileal
inter-position causes foods to stimulate the ileum - increasing GLP-1
secretion.

7.%% M Safety and Efficacy of Exenatide Once Weekly for Treatment of T2DM
Results from 6 randomized, comparator-controlled studies in over 3000 pts
indicate that Rx with exenatide once weekly results in significant glycemic
improvements & weight loss. Gastrointestinal adverse effects ..are common,
but rarely lead to drug discontinuation. Conclusions: Exenatide once weekly
holds promise as a convenient, efficacious, &well-tolerated
antihyperglycemic agent for T2. Studies evaluating outcomes such as CV
events or all-cause mortality with exenatide once weekly are lacking.

8.%%MA Body adiposity index, body fat content & incidence of T2DM
Diabetologia. 2012; 55(6): aim of this study was to compare estimates of
body fat content, i.e. body adiposity index (BAI), BMI & waist & hip
circumferences, with respect to their ability to predict the percentage of
body fat (PBF; confirmed by MRI) & incidence of T2. [ 3 studies= 36,527pts]
Results: BMI more strongly correlated with PBF than BAI while waist
circumference among men & hip circum among women showed the strongest
correlations. BAI was not as strong a predictor of DM as BMI, while waist
circum was the strongest predictor.

9.%% M 7/2 Experimental T1DM Drug DiaPep277Continues to Show Promise
Andromeda Biotech's new drug which is given by injection, improved the
ability of the pancreas to secrete insulin in a phase 3 trial. Pts given
DiaPep277 for at least 1 yr maintained the ability to secrete insulin
significantly better than the group on placebo - with a relative treatment
effect of 23.4%. The treated grp also had fewer hypo events & required less
insulin. [457pts;2yrs] the drug acts by modulating the immune system,
preventing destruction of pancreatic cells that secrete insulin..Reuters
Health Information © 2012 

10.%% Vision Aware 6/28 Are Memory Problems Linked to Eye Disease &
Diabetes? by Maureen Duffy Two recent studies suggest that memory loss &
cognitive decline may be linked to (a)DM, (b) poor control of BS by pts with
DM, and/or (c) damage to retinal blood vessels, called retinopathy.
Retinopathy is a general term that describes damage to the retina, the thin,
light- sensitive tissue that lines the inside surface of the eye. Nerve
cells in the retina convert incoming light into electrical impulses, which
are carried by the optic nerve to the brain. Retinopathy occurs when there
is damage to the small blood vessels that nourish tissue & nerve cells in
the retina. Retinopathy is a frequent complication of DM & uncontrolled high
BSs. This is a leading cause of blindness & low vision among adults in the
US. 
DM & high BP have also been linked to declines in memory & thinking
abilities. A study linking cognitive function & retinal & ischemic brain
changes was seen in the Women's Health Initiative published in the 3/27/12
issue of Neurology. This study examined the assoc between retinopathy &
cognitive decline in older women. Ischemic refers to a decrease in the blood
supply to a bodily organ or tissue, caused by blood vessel constriction or
obstruction. The study suggests that damage to retinal blood vessels could
indicate the presence of similar damage to blood vessels in the brain,
causing problems with cognition, memory & thinking. [511 women;65
plus;10yrs] they had annual tests of mental function, an eye exam 4yrs after
entering the study & brain scans 8 yrs after enrolling. Compared to women
who did not show evidence of vessel damage to the eyes, these women had
lower average scores on the memory & thinking tests. Brain scanning revealed
that they also had more evidence of blood vessel damage within the brain.
The findings suggest that even very early retinopathy may be an indicator
for small vessel disease & a risk factor for blood vessel-related memory &
thinking declines. 
A second study on DM, glucose control & cognitive decline was pub in the
6/18/12 issue of Archive of Neurology-a 10yr study that looked at whether
having DM increased the risk of cognitive decline among elderly persons & if
poor BS control was related to impaired cognitive performance. [6,069pts]
The team found that DM & poor glucose control are assoc with worse cognitive
function which suggests that severity of DM may contribute to accelerated
cognitive aging. Results supports the hypothesis that older adults with DM
have reduced cognitive function & that poor glycemic control may contri-bute
to this association. Future studies should determine if early diagnosis & Rx
of DM lessen the risk of developing cognitive impairment. Ca

11.%%M 7/6 Sharp Rise in Adult Eye Diseases as Baby Boomers Age
Based on the US Census of 2010, the number of people age 50 plus r with late
AMD has increased 25%, the number age 40 plus with open- angle glaucoma has
increased 22%. However there was a 89% increase in diabetic retinopathy in
pts 40 yrs plus from the prevalence in 2000. "It's no surprise that the
numbers of those affected by eye disease are continuing to climb, especially
due to the aging Baby Boomer population," D Friedman, Wilmer Eye Institute
said, This study provides "a call for a need for kind of rethinking how we
deliver care and how we provide better care more efficiently, J Salz, MD, an
ophth. said that frequent exams to detect these conditions early are more
important than ever because early treatment can lead to better vision
outcomes. "This has always been true of glaucoma, but is now important for
macular degeneration & diabetic retinopathy because new treatments
(anti-VEGF [vascular endothelial growth factor] injections, for example) can
result in better outcomes." 

12.%% MPD 7/9 Pump, Real-Time Monitor Best in Type 1 For T1DM,
sensor-augmented pump therapy [SPT] gives better control of blood glucose
than the traditional method of finger- sticks & insulin injections, SH
Golden & team found in a review of 33 randomized, controlled trials. Pts on
SPT, which involves real-time continuous glucose monitoring (CGM) &
continuous insulin infusion, lowered their HbA1c far more than those doing
standard monitoring & injec-tions- in T1 by 0.68% Remove the CGM & there was
little difference between the insulin pump & multiple shots of insulin each
day. The study found that the traditional method of multiple daily
injections & the newer continuous insulin infusion pumps were similar in
terms of their effects on HbA1c for adult & pediatric T1 or T2 pts. without
any difference in severe hypo. This study noted, however, that there was
little evidence available for assessing other outcomes, including severe
hypo or quality of life, between SPT & the most traditional method. Children
with T1 were more satisfied with their Rx if they were on the pump. This
data suggests the approach to intensive insulin Rx can be individualized to
pt preference that will maximize their therapy satisfaction.. Future
research should include larger studies among subpopulations..such as the
elderly, minorities, & those who use insulin to treat T2. Yeh
HC,"Comparative effectiveness & safety of insulin delivery & glucose.. Ann
Intern Med 2012. Ca

13.%% M 7/9 Effects of Some Anti-diabetic & Cardioprotective Agents on Human
Coronary Artery Cells The leading cause of death for pts s suffering from DM
is macrovascular disease. Endothelial [inner lining of blood vessels]
dysfunction is often seen in T2pts & it is considered to be an important
early event in atherogenesis [forming plaques in arteries] & cardiovascular
disease. Endothelium protects the vessels from clotting & inflammatory
factors. It also participates in the regulation of blood flow & BP.
Conclusion - Our results suggest that the anti-diabetic & cardioprotective
agents mentioned above [includes - insulin & metformin] have direct &
beneficial effects on endothelial cell viability & regeneration. This may
increase their clinical utility in T2 pts with endothelial dysfunction that
adversely affects their survival. CV Diabetol. 2012;11(27) 

14.%% M 7/3 New Position Statement on Diabetes Mellitus in Older People "The
effective management of the older patient with DM requires an emphasis on
safety, DM prevention, early Rx for vascular disease, & functional
assessment of disability due to limb problems, eye disease, & stroke. In
addition in older age, prevention & manage-ment of other DM-related
complications & assoc conditions, such as cognitive dysfunction, &
depression, become a priority," authors say. Glucose Targets, individual
comorbid conditions, as well as cognitive & functional status, should be
considered in deter-mining glucose goals, but in general they recommend a
HbA1c target range of 7-7.5%. Low glucose states (glucose levels < 5.0
mmol/L) should be strictly avoided. BP threshold for Rx of hypertension is
140/80mm Hg (150/90 for pts age 75 +) All pts should have an individ
physical activity program that includes resistance training, balance EX, &
CV fitness training. supported by the Internat Assoc of Geriatrics &
Gerontology & European DM Working Party for Older People. JAMDA. 2012;13:

15.%% M 7/10 Diabetes & Frailty: An Emerging Issue - .. DM is a premature
ageing syndrome & shares some of the key characteristics of frailty..which
is a state of increased vulnerability to stressors that results from
decreased physiological reserve .. Sarcopaenia is the loss of muscle mass
assoc with aging. The maintenance of skeletal muscle mass is influenced by
multiple factors including hormonal, inflammatory, neurological, nutritional
& limb activity.. Sarcopaenia by way of its profound effects on lower limb
function is a potentially important contributor to the disabling condition
associated with DM & may be a precursor to frailty..Part 1: Sarcopaenia
&Factors Affecting Lower Limb Function British J of Diab& Vascular Disease.
2012;12(3):

16.%% ARVO 2012 7/11 Retinal Disease: Advances in Treatment
R Steinert, MD; B Kuppermann, MD, PhD UC Irvine Ophthalmology Our task today
is to discuss (ARVO) meeting, particularly with reference to the topics on
retina. Dr. S I would like to gear this toward non-retina specialists, which
is still most of us..CATT is a landmark (NIH)-funded trial that compares
bevacizumab [avastin] with ranibizumab [lucentis] for treatment of wet
macular degeneration. Bev.. is the monoclonal antibody of vascular
endothelial growth factor (VEGF) approved by (FDA) for systemic use in
certain cancers, whereas rani.. is the antigen-binding fragment of that
antibody developed specifically for the eye. Bev.was discovered, to be
useful in small doses intravitreally [injected into the jelly part of the
eye] to treat wet macular degeneration with choroidal neovascularization.
[growth of new abnormal blood vessels] The retina community used
intravitreal bev. for about a year before rani.. was approved by FDA; this
is going back 5-7 yrs. Since that time, both drugs have been used
extensively for wet AMD, with seemingly similar benefits to patients. A
question arose, however, as to how similar these 2 compounds were in
treating wet AMD -- This led to the CATT study in an attempt to compare the
safety & efficacy of these 2 drugs.. also to determine whether aggressive,
as-needed injections provided similar efficacy as fixed regimen injections
every 4 wks. It was a noninferiority study, which is a little bit
complicated statistically, & it had 4 arms based on drug & dosing schedule.
What we saw last year was that bev Q4 wks was noninferior to ranibizumab
Q4wks.Rani PRN was also noninferior to [both drugs] every 4 wks. Basically,
the results of year 1 were corroborated at year 
Anti-VEGF Therapy for Diabetic Macular Edema - Our off-label use of bev for
DM mac edema didn't seem to be quite as effective during the first clinical
trial..In that DRCR.net protocol, I saw that ranibizumab, on a monthly
basis, had dramatically better results than laser -- and, in fact, better
results than steroids injected every 4 months...
The Human and Nonhuman Genome - J. Craig Venter, one of the preeminent
authorities in genetics & genomics has been looking at the impact of the
nonhuman genome on humans in our close environ-ment. Apparently animals,
including humans, are releasing epithelial cells all the time, which are
lifted into the air that we then breathe in. He sampled air in midtown
Manhattan 20 stories up, & found that more than 50% of the air contained
rodent DNA...there is now a large effort on looking at all the things in the
human body that are nonhuman ..It turns out that something like only 10% of
the genes in the human body are human. The rest are bacterial, from our gut
& various organs. it could be that the bacterial genes in our body are
altering the environment & therefore modifying our own genetic expression.
But it's interesting how the bacteria in our body play such a vital role in
our health. It's very much a symbiotic relationship.There are pathogens that
are our enemies, but the overwhelming majority of the bacteria in our body
are our friends. There is a huge effort under way called Metagenomics of the
Human Intestinal Tract (MetaHIT),to perform genetic analysis of all these
additional genes in the human body that are not human genes. Medscape Oph ©
2012 WebMD, LLC

17.%% M 7/16 Resting-state Brain Networks in T1 Patients With & Without
Microangiopathy (MA).. Cognitive functioning depends on intact brain
networks that can be assessed with functional magnetic resonance imaging
(fMRI). [101pts;48 controls] MA+ pts showed decreased connectivity in
networks involving [includes] attention, memory, auditory & language
processing... Better information- processing speed & general cognitive
ability were related to increased connectivity. T1DM is associated with a
functional reorganization of neural networks that varies, dependent on the
presence or absence of microangiopathy [disease of capillaries, leaking,
etc] All pts had a detailed neuropsychological assessment. MA+ pts were
significantly older & reported the highest number of depressive symptoms
compared with both other groups. Compared with MA-pts, MA+ patients had an
earlier onset age & longer disease duration, & a higher rate of
hypertension. Diabetes.2012;61(7) 

18.%% Hormone Discovered That Preserves Insulin Production & Beta Cell
Function in Diabetes Duke U researchers have found protective, anti-DM
functions for a hormone that, like insulin, is produced by the islet cells
of the pancreas. TLQP-21 was found to stimulate insulin secretions from rat
& human islet cells & protect islet cells. This discovery could open to
further research toward prevention & treatments for T1DM & T2DM. The team
gave TLQP-21 to diabetic fatty rats, which have a genetic propensity to
develop T2. There was significant improvement in insulin & glucose levels &
less beta cell deaths in the treated animals. Finding a way to produce more
of this protective hormone could be valuable in the Rx of DM. ..the team
plans to test the hormone in T1 in future studies. TLQP-21 is similar to
another naturally occurring hormone produced in the digestive tract, a
glucagon-like peptide-1(GLP-1). What's exciting is that in the animal
studies of TLQP-21, no consequential side effects were seen. The study rats
ate normal amounts of food, & didn't show any changes in heart rate or
digestion patterns when they were given large doses of the hormone. The next
step is to find a small molecule that could stimulate the islet cells to
produce more of the TLQP-21 hormone, or to develop more potent versions of
the injected hormone. www.dukehealth.org/health_library/news/

19.%% ASMBS 7/16 Abandon Gastric Banding Bariatric Surgery, Say Experts L
Angrisani, Italy presented 10-yr fup data from a randomized trial [51pts]
comparing laparoscopic Roux-en-Y gastric bypass with banding "There is no
point in doing further study comparing bypass with banding..If you consider
revisions & failures, only 26% of the banding pts had..a successful weight
loss," Of the 24 bypass pts in his study 1 had T2. Europeans ..started
banding procedures before North Amer, & therefore detecting problems
earlier, said Dr. A. "This is a very common story. While Europeans accept
the messages from the US world of surgery, the US community does not accept
data coming from Europe. "The European experience is more mature than the US
experience with gastric banding," agreed J Morton, Stanford "although 6-yr
data for sleeve gastrectomy indicate that it is safe & effective, the
potential long-term complications for the sleeve may not be fully apparent
yet, & ..banding may still be preferred due to it's favorable short-term
safety profile." [see #6 for sleeve effect on T2] 

20.%% ADA 7/16 Effects of Roux-en-Y Gastric Bypass Surgery in Pts with T2 &
Only Mild Obesity RYGB ameliorates T2 in severely obese pts through
mechanisms beyond just weight loss .. We studied the long-term impact of
RYGB on pts with DM & class I obesity [66 pts BMI 30–35kg/m;fup 6yr] Weight
loss failed to correlate with several measures of improved glucose
homeostasis, C-peptide responses to glucose increased substantially,
suggesting improved ß-cell function. There was no mortality, major surgical
morbidity, or excessive weight loss. Hypertension & dyslipidemia also
improved, yielding 50–84% reductions in predicted 10-yr CVD risks of fatal &
nonfatal coronary heart disease and stroke. Conclusions: The effect of RYGB
on DM is impressive. Approx 80–85% of severely obese patients with T2 who
undergo this operation experience full remission of DM.. Routine clinical
use of RYGB, however, remains bounded by a 1991 NIH consensus statement,
which set limits for the use of bariatric surgery at BMI at 35 kg/m2
..required to approve surgical obesity Rx. Pts with a BMI between
30-35(class I obesity) are the most numerous group of obese persons.
Patients with T1 or undetectable ß-cell function were excluded from this
study. DM remission was defined as HbA1c <6.5% without use of any DM meds.
Diabetes was considered improved if pts still required oral medication at
lower dosages than [before surg] (but no insulin) & had HbA1c <7.0%.: At the
latest f-up 88% of pts had remission [measured as above]11% had improved
DM,& 1 did not have a clear change in glycemic control. Remission occurred
between 3 & 26 weeks after RYGB.. We found no relationship between change in
body weight & change in HbA1c or the magnitude of improvement in ß-cell
sensitivity to glucose. World Congress InterventionalRx for r T2 & Internat
DM Fed thought leaders recommended that RYGB be considered to treat poorly
controlled T2 in pts with BMI 30–35 kg/m 2.. Additional data are needed from
RCTrials before routinely recom-mending RYGB in pts with BMI <35 [less
than]DiabetesCare2012;35(7)

21.%% NatREndo 7/20 Muscles, exercise & obesity: skeletal muscle as a
secretory organ Studies in the past few years suggest the existence of yet
unidentified factors, made by muscle cells, which may influence cancer cell
growth & pancreas function [pancreas is the source of insulin]. Many
proteins produced by skeletal muscle need muscle movement to be secreted;
this fact could be a potential mechanism for the assoc between sedentary
behaviour & many chronic diseases. [ie T2]

22.%% NREndo 7/20 CV risk in double DM- when 2 worlds collide Historically,
clinical management of pts with T1 has been focused on BS control, which is
sometimes achieved at the expense of weight gain on intensive insulin
regimes. Several studies have concluded that factors related to obesity,
metab syndrome & insulin resistance [IR] are more important than HbA1c for
prediction of CV risk. 'Double DM’ is a combination of T1 & characteristics
of T2 including central [obesity] & worsened IR.

23.%% M 7/23 Hepatitis B [HB] Vaccine for Adults With DM T.Murphy MD,
Centers for Disease Control & Prevention. CDC's Advisory Com on Immunization
Practices recently added adults with both T1 &T2 to the list of persons at
increased risk for hepatitis B infection & recom-mended that they receive
HBvaccination. Study by CDC [800 cases] of acute HB adults with DM younger
than 60 had twice the risk for acute hepB infection as those without DM of
the same age. Adults with DM over 60 were also at increased risk for HB
infection, but the increase was not statistically significant. CDC now
recommends HBvac for all unvaccinated diabetics younger than 60. Vaccination
should occur as soon as possible after diagnosis of DM should also be given
to adults diagnosed with diabetes in the past. Vac. requires 3 doses at 0,
1, & 6 m. Factors that might support vaccinating adults with DM age 60yrs
plus include recent diagnosis of DM in older adults with generally good
health. HepB is a viral infection of the liver that can cause serious
illness in adults–about 40% of adults with HB need hospitalization, 4% die
from early complications of the infection. Among adults with chronic HB 15%
progress to cirrhosis & liver failure or liver cancer.

24.%% M 7/24 Sexual Function Diminished in Women With Diabetes
Middle-aged women with DM reported lower levels of sexual desire,
satisfaction, & frequency than their nondiabetic counterparts. Women with
insulin-treated diabetes also reported more difficulty with lubrication,
unlike women with DM who did not need insulin.[2270 women;40-80yrs] A
Rapkin,UCLA whowas not involved in this study, agreed with the authors' that
Rx of women with DM should include a sexual history & clinicians should
counsel pts that preventing end- organ complications may help preserve their
sexual function. Funded Nat Inst DM, Digestive &Kidney Diseases (NIDDK)

25.%% MPD 7/25 FDA Panel to Mull Diabetic Eye Disease Drug
Genentech's blockbuster eye drug ranibizumab (Lucentis) helped improve
vision for DM pts with macular edema [DME] but the drug's higher of 2 doses
comes with more adverse events. Rani.. is already approved to treat wet AMD
& macular edema following retinal vein occlusion. The committee will
consider whether to support an indication for DME. For the past 30 yrs, it's
been treated with laser photocoagulation; however, few pts notice a benefit
in vision.Further, laser can destroy retinal tissue & decrease sensitivity
to color. The application is based on 2 randomized, double-blind,
sham-controlled 3yr studies of 750 pts who had injections of either 0.5 or
0.3mg of the drug or placebo, once a month for 24m/.. Re adverse effects,
11pts in the 0.5-mg group died, as did 7 in the 0.3-mg group, & 3 on
placebo. (rates 36.4%,32.4%, & 33.2%, respectively.) Specific adverse events
included: Myocardial infarction, Pneumonia, Kidney failure. The number of
eye-related adverse events were similar in all Rx groups. The advisory
committee will vote Thursday on whether the drug is safe and effective, and
if so, which dose should be approved.
%% 7/26 Panel Says OK --advisory com voted unanimously on thurs to recommend
approval of a new indication for ranibizumab for the treatment of DME. There
was unanimity on the lower 0.3 mg dose;the 0.5 mg dose won members' assent
with an 8-2 vote.

26.%% M 7/26 Effects of Linagliptin Persist in Treatment Extension
Linagliptin safely controls BS in pts with T2 .. [2000pts;102wks] all pts
started with inadequately controlled T2DM & received placebo or oral
linagliptin 5 mg as daily only , or in addition to metformin, metformin plus
a sulfonylurea, or pioglitazone. Author said "With linagliptin monotherapy,
the HbA1c change from baseline to wk102 was –0.5%," The overall incidence of
adverse events was 81% of those14.3% were drug-related The most common
adverse events were hyper or hypo-glycemia, nasopharyngitis, upper
respiratory tract infections, and urinary tract infections. "Linagliptin as
monotherapy or in combo. with other oral glucose-lowering agents is a safe &
effective option for the long-term treatment of T2," study sponsored by
Boehringer Ingelheim. Int J Clin Pract. 2012;66:


3rd International Congress on Abdominal Obesity (ICAO).
American Society for Metabolic and Bariatric Surgery (ASMBS) 29th
ENDO 2012: The Endocrine Society 94th Annual Meeting

%% Abbreviations-acronyms fup-follow up; pt - patient/participant ; DM -
diabetes Mellitus; T1- type 1 DM;T1A -autoimmune T1; T2 - type 2; DME -
diabetic macular edema;DR - DM retinopathy; BS/BG- blood sugar/glucose;
HA1C, glycated hemoglobin A1C; BP -blood pressure; CVD - cardio-vascular
disease; IR- insulin resistance; OCT-optical coherence tomography; BCVA -
best corrected visual acuity; RYGB- Roux-en-Y gastric bypass; RCT
-Randomized controlled trial; ADA - Am Diab Ass;J- Joslin DMCenter; M-
Medscape Web MD; MA- Medline Abstract, MP- Medline Plus; MPD - Med Page
Today; NEI - Nat Eye Institute;SciA-Scientific Amer. Definitions via online
Medical dictionaries. Disclaimer, I am a BSN RN but not a diabetic or
diabetic educator. Assistant Editor: Cam Acker, 50yr DM survivor. Reports
excerpted unless otherwise noted. [translations/explanations by thl] This
project is done as a courtesy to the blind/visually impaired & diabetic
communities. Dawn Wilcox RN BSN Coordinator The Health Library at Vista
Center; an affiliate of the Stanford Hospital Health Library. contact above
e-mail or thl at vistacenter.org

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