Diabetes Spectrum最新文献

{"title":"First-Generation Anti-Obesity Medications.","authors":"Sarah R Barenbaum, Mohini Aras","doi":"10.2337/dsi24-0003","DOIUrl":"10.2337/dsi24-0003","url":null,"abstract":"<p><p>The development of second-generation anti-obesity medications (AOMs) has transformed the treatment of obesity. However, the first-generation AOMs are still essential tools in the treatment of obesity. The decision of which AOM to initiate must be individualized taking into account patient preference, safety, tolerability, cost, and supply.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"37 4","pages":"296-302"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Obesity Treatment: Considerations for Diabetes Educators and Clinicians.","authors":"Helena H Laroche, Cristina Fernandez, Brooke R Sweeney, Meredith L Dreyer Gillette, Sarah E Hampl","doi":"10.2337/dsi24-0005","DOIUrl":"10.2337/dsi24-0005","url":null,"abstract":"<p><p>Prevalence rates of pediatric obesity and diabetes are rising, and pediatric health care professionals are ideally situated to address these chronic diseases using a patient- and family-centered approach. This article reviews key elements of evaluation that can inform treatment and emphasizes a comprehensive, team-based strategy. Treatment begins with motivational interviewing and building a foundation of intensive health behavior and lifestyle treatment, followed by pharmacotherapy and metabolic and bariatric surgery, when indicated.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"37 4","pages":"313-324"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Second-Generation Anti-Obesity Medications.","authors":"Sarah H Schmitz, Louis J Aronne","doi":"10.2337/dsi24-0002","DOIUrl":"10.2337/dsi24-0002","url":null,"abstract":"<p><p>Second-generation anti-obesity medications are more effective than their first-generation predecessors, resulting in an average weight loss of 15% when combined with lifestyle modifications. This article examines the efficacy and therapeutic implications of the three currently approved second-generation medications: setmelanotide for individuals with monogenic forms of obesity, semaglutide 2.4 mg, and tirzepatide. Particular emphasis is placed on the concurrent treatment of obesity and type 2 diabetes with semaglutide 2.4 mg and tirzepatide.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"37 4","pages":"303-312"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guideline-Directed Approach to Obesity Treatment.","authors":"Ariana M Chao, Alexandra Paul, Josef V Hodgkins, Thomas A Wadden","doi":"10.2337/dsi24-0001","DOIUrl":"10.2337/dsi24-0001","url":null,"abstract":"<p><p>This article summarizes and compares 18 sets of guidelines for adult obesity treatment, highlighting key recommendations for patient evaluation, lifestyle intervention, anti-obesity medications (AOMs), and metabolic and bariatric surgery. Guidelines are consistent in many regards, although there is divergence regarding preferred AOMs. Metabolic and bariatric surgery is still recognized as the most durable form of obesity treatment, and newer guidelines suggest these procedures at lower BMI thresholds for people with uncontrolled type 2 diabetes. Overall, guidelines for obesity treatment show a high degree of agreement, although updates are needed to incorporate new treatment innovations.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"37 4","pages":"281-295"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life Lessons and Diabetes Research.","authors":"Paula M Trief","doi":"10.2337/ds24-0065","DOIUrl":"10.2337/ds24-0065","url":null,"abstract":"<p><p>This article was adapted from the address Dr. Trief delivered as the recipient of the American Diabetes Association's Richard R. Rubin Award for 2024. This award recognizes a behavioral researcher who has made outstanding, innovative contributions to the study and understanding of the behavioral aspects of diabetes in diverse populations. Dr. Trief delivered the address in June 2024 at the Association's 84th Scientific Sessions.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"108-114"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned: Diabetes Education for One and for All.","authors":"Patti Urbanski","doi":"10.2337/ds24-0067","DOIUrl":"10.2337/ds24-0067","url":null,"abstract":"<p><p>This article is adapted from a speech Ms. Urbanski delivered in June 2024 as President, Health Care & Education, of the American Diabetes Association. She delivered her address at the Association's 84th Scientific Sessions.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"101-107"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Standardized Obstetrics Insulin Drip Protocol and Order Set.","authors":"Margaret Davis, Kristina Naseman, Noelle Leung, Aric Schadler","doi":"10.2337/ds24-0011","DOIUrl":"10.2337/ds24-0011","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of pregnancies affected by diabetes is increasing, with the Centers for Disease Control and Prevention reporting that 1-2% of pregnant women have type 1 or type 2 diabetes and up to 10% of pregnancies are affected by gestational diabetes as of 2018. Maternal glycemic management is directly related to fetal and neonatal outcomes, and aberrant maternal hyperglycemia has known negative outcomes. Although most of glycemic management centers on outpatient treatment, evidence exists to support the use of intravenous insulin drips during inpatient admissions. This study aimed to evaluate an intravenous insulin protocol specific to the obstetric (OB) population.</p><p><strong>Research design and methods: </strong>This was a single-center retrospective pre-/post- cohort study of OB patients with diabetes admitted to an academic medical center. Groups were differentiated based on admission date and protocol implementation with a 6-month washout period. Included patients received an intravenous insulin drip around either antenatal corticosteroid administration or during labor and delivery. Those who were within 7 days of receiving a diabetic ketoacidosis diagnosis or who were admitted to an intensive care unit were excluded.</p><p><strong>Results: </strong>Fifty-nine patients received 69 distinct insulin drip orders. Twelve drips were included in the group admitted before initiation of the insulin drip protocol (pre-group) and 57 in the group admitted after the protocol went into effect (post-group). Time spent within the goal glucose range while on an insulin drip in the pre-group was 1.63% compared with 39.30% in the post-group (<i>P</i> <0.001). Glucose levels <70 mg/dL was 0.00% in the pre-group compared with 3.23% in the post-group (<i>P</i> = 0.045). There were no differences in severe hypoglycemia (glucose <50 mg/dL), hyperglycemia (glucose >110 mg/dL), or neonatal outcomes.</p><p><strong>Conclusion: </strong>Implementation of a nursing-driven, obstetrics-specific intravenous insulin drip protocol significantly improved maternal glycemic management within a goal glucose range of 70-110 mg/dL during antenatal corticosteroid administration and labor and delivery.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"68-74"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Efficacy of Type 2 Diabetes Group Training Courses With and Without the Integration of mHealth Support in a Controlled Trial Setting: Results of a Comparative Pilot Study.","authors":"Melanie Roth, Johanna Bodenhofer, Magdalena Fischill-Neudeck, Caroline Roth, Michael Domhardt, Gerlinde Emsenhuber, Babette Grabner, Gertie J Oostingh, Anja Schuster","doi":"10.2337/ds24-0012","DOIUrl":"10.2337/ds24-0012","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the effects on type 2 diabetes self-management education provided in group courses with or without a supporting smartphone application (the DM2CUA app).</p><p><strong>Research design and methods: </strong>This open-label, cluster-randomized, controlled, multicenter pilot study involved three Austrian diabetes educational group courses. People with type 2 diabetes in the control group received a regular educational group course, whereas those in the intervention group received the same course plus the use of the DM2CUA app. The app prompted participants to carry out educational tasks that were discussed in the course. After the last lesson, the app provided participants with relevant messages for another 4 weeks. The primary outcome measure was the Diabetes Self-Management Questionnaire score assessed at four time points. Secondary outcome measures included scores on the Diabetes Distress Scale and the Health Education Impact Questionnaire and A1C levels.</p><p><strong>Results: </strong>Participants in the intervention group already had a higher level of diabetes self-management at the start, but the median score showed further improvement during the entire study period.</p><p><strong>Conclusion: </strong>Findings from this pilot study suggest that the DM2CUA app may have a positive impact on diabetes self-management.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"58-67"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons on Diabetes From the Front Line: The Impact of Armed Conflict on Ukrainians With Diabetes: The TeleHelp Ukraine Initiative.","authors":"Ji Won Susie Yoo, Rahul D Barmanray","doi":"10.2337/ds24-0003","DOIUrl":"10.2337/ds24-0003","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"75-81"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-Urban Disparities in the Uptake of New Diabetes Medications.","authors":"Benjamin Zhu, Dong Ding, Jing Luo, Sherry Glied","doi":"10.2337/ds23-0075","DOIUrl":"10.2337/ds23-0075","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed rural-urban differences in the uptake and use of glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium-glucose cotransporter 2 (SGLT2) inhibitors among U.S. adults with diabetes.</p><p><strong>Research design and methods: </strong>We calculated person-level annual total and out-of-pocket (OOP) expenditures for new, other, and all diabetes medications in the Medical Expenditure Panel Survey. We defined newer diabetes medications as GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT2 inhibitors. The primary outcome was whether a person received a new diabetes medication during the year, and secondary outcomes were medication expenditures. The key independent variable was metropolitan statistical area (MSA) status. Logistic regression was used to estimate use rates of new diabetes medications by MSA status, and a two-part model was used to estimate individual-level annual total and OOP expenditures on new, other, and all diabetes medications.</p><p><strong>Results: </strong>We observed no significant difference (adjusted odds ratio 0.943, <i>P</i> = 0.37) in newer diabetes medication use. Individuals with diabetes in non-MSAs were more likely to have spending (probit coefficient 0.058, <i>P</i> = 0.06) and to spend more on other diabetes medications (combined marginal effect $103.13, <i>P</i> = 0.09), although this result was not statistically significant. This imbalance increased from $81.33 (<i>P</i> = 0.09) in 2003-2006 to $136.66 (<i>P</i> = 0.08) in 2017-2020.</p><p><strong>Conclusions: </strong>Rural-urban diabetes outcome disparities are not likely to be the result of differences in the uptake of GLP-1 receptor agonist, DPP-4 inhibitor, and SGLT2 inhibitor medications.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"49-57"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}