Diabetes Disparities and Differences

Diabetes Diagnosis Disparities.

Diabetes prevalence, rates of diagnosis, and rates of effective treatment vary significantly among US counties. Ranges in 2012: total diabetes prevalence, 8.8% to 26.4%; total diagnosed cases, 59.1% to 79.8%; and successfully treated patients, 19.4% to 31.0%. From 1999 to 2012, total diabetes prevalence increased in all counties, rates of diagnosis increased, and rates of effective treatment stagnated. The findings could help health care providers identify areas of greater need.

Type 2 Diabetes in Youth Consensus Report.

Type 2 diabetes in youth clearly differs from type 1 and more closely resembles the pathophysiology in adults-insulin resistance and nonautoimmune β-cell failure-but displays unique aspects (eg, rapidly progressive β-cell decline and accelerated development of diabetes complications). Treatment options-insulin, metformin, and a healthy lifestyle-are limited and inadequate. Study authors called for innovative for research, prevention, and treatment strategies.

Antiobesity Drugs vs SGLT2s.

The number of dispensed antidiabetes prescriptions was 15 times that of antiobesity prescriptions in 2012-2015. The adoption rate of sodium-glucose co-transporter 2 inhibitors was nearly exponential and that of antiobesity pharmacotherapies was linear. Researchers suggested there are systematic barriers against prescribing antiobesity pharmacotherapies considering the relative prevalences of obesity and diabetes and that obesity is a major cause of diabetes.

Can an Old Diabetes Drug Perform New Tricks?

Investigators studied the anti-inflammatory effects of the diabetes drug metformin and their relationship to antihyperglycemic properties to determine their possible contribution to the drug’s cardiovascular disease benefit. They found that anti-inflammatory properties are exerted irrespective of diabetes status and suggested their work supports further investigation into repurposing metformin in a broader spectrum of patients with CVD.

Diabetes and Psoriasis Share Atherosclerosis Burden.

Rates of subclinical atherosclerosis were similarly high in patients with type 2 diabetes and in those with moderate to severe psoriasis based on increased coronary artery calcium scores. Psoriasis was independently associated with the presence of any coronary artery calcium; the association with diabetes was no longer significant after adding body mass index to the model. Atherosclerosis rates are high in patients with psoriasis beyond adjustment for BMI.

More Diabetic Retinopathy Vision Impairment.

Of 32.4 million blind and 191 million visually impaired persons worldwide in 2010, 0.8 million were blind and 3.7 million were visually impaired because of diabetic retinopathy, up 27% and 64%, respectively, since 1990. Diabetic retinopathy accounted for 2.6% of blindness and 1.9% of moderate and severe vision impairment worldwide in 2010, up from 2.1% and 1.3% in 1990. Poor blood glucose control and limited access to eye health services are major factors.

Let Them Eat Fish.

A decreased risk of sight-threatening diabetic retinopathy in middle-aged and older persons with type 2 diabetes is associated with intake of at least 500 mg/d of dietary long-chain ω-3 polyunsaturated fatty acids. The authors of a prospective study within the randomized clinical trial Prevención con Dieta Mediterránea suggested this is easily achievable with 2 weekly servings of oily fish.

An SGLT2 Inhibitor Boosts Kidney Health.

In patients with type 2 diabetes, sodium-glucose cotransporter 2 inhibition with canagliflozin slowed renal disease progression over 2 years to a greater extent than glimepiride. Patients had reductions in HbA1c, body weight, blood pressure, and albuminuria. Canagliflozin may confer renoprotective effects independent of its glycemic effects.