Contents

Search

diabetes mellitus type 2 (insulin-resistant)

also see diabetes in the elderly Etiology: 1) insulin resistance a) decreased numbers of insulin receptors b) post-receptor mechanism 2) impaired beta-cell function - loss of 1st phase of insulin secretion 3) mutations (rare) a) insulin b) insulin receptor c) glucokinase 4) risk factors (see risk factors for diabetes mellitus type 2) a) age > 45 years b) obese individuals c) western culture diet - gut microbiome may play a role [107] - red meat consumption [264] d) lack of exercise e) previous gestational diabetes f) impaired glucose tolerance g) higher fasting plasma glucose within the normal range is a risk factor for young men [25] h) black, hispanic or native American ethnicity i) habitual sleep duration of < 6 hours/night - irregular sleep patterns [286] j) hypertension - ACE inhibitors & ARBs lower risk of diabetes [247] - diuretics & beta-blockers increase risk of diabetes [29,112,247] k) dyslipidemia - use of statins [112] l) smoking (see CARDIA study) m) increased weight gain relative to height during an infant's first 3 months of life [49] n) sedentary lifestyle, including watching TV [138] o) systemic absorption of topical glucocorticoids [219] p) systemic absorption of inhaled glucocorticoids [220] q) polycystic ovary syndrome [3] Epidemiology: - common in developed nations - sugar availability in a country is related to the prevalence of diabetes [97] - prevalence of diabetes in U.S. adults has more than doubled since 1976 (from 4.7% to 11.2%) [129]; 12-14% [143] - prevalence is higher among Blacks, Hispanics, & Asians (> 20%) than among whites (11%) [143] - in men, the rise is not explained entirely by increasing obesity [129] - incidence of type 2 diabetes increased from 9.0 to 12.5 cases per 100,000 youths; largest increases in racial & ethnic minority groups [170] - > 25% of patients with diabetes have not been diagnosed [131] - decrease in overall mortality 1998-2014 lower in patients with type 2 diabetes than in control population [171] - men at greater risk of complications diabetes complications than women [277] Pathology: 1) disease often present for 5-10 years prior to diagnosis - retinopathy, neuropathy & nephropathy are commonly seen at clinical presentation 2) overnutrition results in insulin resistance & metabolic syndrome through increases sympathetic nervous system activity [285] 3) non-enzymatic glycosylation of proteins (formation of AGE pigments) 4) abnormalities in neutrophil function [3] a) defective chemotaxis b) impairment of neutrophil phagocytosis 5) endothelial dysfunction associated with insulin-resistance 6) insulin resistance correlates with & may be caused by RBP4 7) effects of glucagon-like peptide may be attenuated 8) glucagon NOT supressed in post-prandial state 9) adipokines resistin & adiponectin may play a role - in mice, raising circulating levels of adiponectin protects against insulin resistance & glucose intolerance [113] Genetics: 1) stronger genetic susceptibility than type 1 diabetes 2) 25% probability of having affected parent or sibling 3) may be associated with mutation in the peroxisome proliferator receptor-gamma (PPAR-gamma) 4) associated with defects in MAPK8IP1 5) susceptibility to diabetes mellitus type 2: PPP1R3A, MCF2L2, TCF7L2 6) susceptbility to microvascular complications: - polymorphism(s) in EPO, SOD2 7) loss of function of SLC30A8, (Zn+2 transporter) diminishes risk of type 2 diabetes [115] - SLC30A8 variant Trp-325 is a risk factor that confers susceptibility to diabetes mellitus type-2 8) other implicated genes INPPL1, CAPN10, MT-ND1, SLC22A2, AKT2, TGM2, HNF1B, ADRB3, INSR, GCGR, ABCC8, GLUT4, UCP1, BTC, KCNJ11, PDX1 Clinical manifestations: 1) symptoms insidious in onset 2) polyuria 3) polydipsia, polyphagia 4) fatigue 5) chronic cutaneous infections 6) yeast vaginitis 7) blurred vision 8) diabetic retinopathy: a) often present at the time of diagnosis b) retinal microaneurysms c) dot-blot hemorrhages d) macular edema 8) peripheral neuropathy a) classic stocking-glove pattern - paresthesias, especially of feet b) cranial nerve III palsy 9) most patients are obese (> 120% of ideal body weight) Laboratory: 1) diagnosis: - 8 hr fasting plasma glucose > 126 mg/dL on 2 separate occasions - HgbA1c of >= 6.5% - plasma glucose > 200 mg/dL 2 hr after 75 ng oral glucose tolerance test - random plasma glucose > 200 mg/dL with symptoms of hyperglycemia 2) glucose tolerance test if glucose 120-140 mg/dL 3) urinalysis a) glycosuria: occurs when serum glucose exceeds renal threshold, about 175 mg/dL; renal threshold may be as high as 250-300 mg/dL in diabetics b) proteinuria: albumin normally 10% of urine protein normal: < 100 mg or protein excreted in urine per day c) albumin/creatinine ratio at diagnosis & annually thereafter d) urinary free cortisol to rule out Cushing's syndrome in newly diagnosed patients [3] 4) glycated hemoglobin a) hemoglobin A1c (also see glycemic control) targets: - < 7.0% if mild or no microvascular complications & life expectancy > 10 years - 7%-8.5% if microvascular or macrovascular complications, comorbid conditions, or life expectancy of 5-10 years - 8%-9% if advanced microvascular or macrovascular complications, severe comorbid conditions, difficulties with self-management, or life expectancy < 5 years [180] b) total glycated hemoglobin c) measure every 6 months if treatment at goal [3] - every 3 months if treatment is being adjusted to optimize glycemic control [3] 5) C-peptide in serum is measurable - repeat C-peptide in serum if initially low prior to switching to oral hypoglycemic (metformin) in newly diagnosed patients initially managed with insulin [3] 6) serology: - failure of oral hypoglycemics in recently diagnosed type 2 diabetes - misdiagosed type 1 diabetes - glutamate decarboxylase 65 antibody in serum - ICA1 autoantibody 7) basic metabolic panel for serum glucose, serum creatinine (eGFR) 8) fasting lipid panel at diagnosis & annually in adults 40-75 years of age [3] 9) blood glucose monitoring not recommended for type-2 diabetes not treated with insulin unless monitoring facilitates lowering of hemoglobin A1c [263] 10) see ARUP consult [85] Special laboratory: - funduscopy to assess diabetic retinopathy at diagnosis & yearly thereafter* (see diabetic retinopathy) - 10 g monofilament exam, 128 Hz tuning fork & ankle reflexes - at diagnosis, annually thereafter [3] - routine screening for coronary artery disease in asymptomatic patients with diabetes mellitus does not reduce mortality [4,142] - routine myocardial perfusion screening of no benefit [47] - cardiac stress testing every 2 years if known CAD [3] - consider ankle-brachial index if > 50 years of age * within 5 years if < 30 years of age Radiology: - coronary computed tomography angiography of no benefit in calibrating intensity of preventive therapy in patients with diabetes mellitus [133] Differential diagnosis: - mature onset diabetes of the young (MODY) - young adult with lean body type - strong family history of diabetes Complications: 1) also see diabetes mellitus complication 2) increased mortality - especially when diagnosed at a younger age [213] - 3-fold increase in mortality from pneumonia & influenza [25] - cancer may exceed cardiovascular disease as a leading cause of death in adults with type 2 diabetes [256] - mortality from colorectal cancer, pancreatic cancer, liver cancer, & endometrial cancer may contribute [25] - increased risk of cardiac arrest with drugs that prolong QT interval, especially fluoroquinolones, mocrolides & antipsychotics [265] 3) increase in fatal myocardial infarction (MI) in diabetics a) two-fold increase in diabetic men b) three-fold increase in diabetic women c) manifestations of angina & MI are often atypical d) incidence of silent myocardial infarction is high e) if well controlled diabetes mellitus & well-controlled hypertension, coronary artery disease & MI are the major risks 4) increased incidence of peripheral vascular disease & ischemic stroke 5) hyperlipidemia 6) diabetic nephropathy - GLP-1 agonists & SGLT-2 inhibitors diminish risk of hyperkalemia in patients taking ACE-inhibitors or ARBs [281] 7) diabetic retinopathy 8) diabetic polyneuropathy - diabetic foot 9) gastroparesis - gastric emptying generally accelerated in diabetes - gastroparesis may be associated with small intestine bacterial overgrowth [260] 10) cognitive impairment - may be increased incidence of dementia - contributions from ischemia & hypoglycemia [46] - hypoglycemia increases risk of cognitive impairment [103] - cognitive impairment increases risk of hypoglycemia [103] - hyperglycemia increases risk of cognitive impairment [156] - advanced glycosylation end products may damage neurons & vascular endothelium [156] - increased risk of cognitive impairment in patients with diabetes mellitus at midlife [136] - largely due to impairments in processing speed & executive function, processes generally associated with white matter tracts & subcortical gray matter affected by cerebrovascular disease [136] - diabetes mellitus type 2 for >10 years doubles risk of dementia at age 70 [237] - dulaglutide may attenuate cognitive decline in diabetics with additional cardiovascular risk factors [229] 11) may increase risk of acute pancreatitis [64] 12) at any given T-score or FRAX score, risk of fracture is increased relative to non-diabetic patients [68] 13) erectile dysfunction in men & diminished sexual satisfaction in women [89] 14) rheumatological complications a) Dupuytren contracture b) adhesive capsulitis of the shoulder c) diabetic amyotrophy d) carpal tunnel syndrome e) diffuse idiopathic skeletal hyperostosis (DISH) f) gout is common [188] 15) acanthosis nigricans 16) hypoglycemia - especially with insulin, especially in the elderly - emergency department visits common - subsequent hospitalization common 17) hyperglycemic hyperosmolar coma more common than diabetic ketoacidosis [3,149] 18) diagnosis prior to age 40 associated with more lifetime hospitalizations & a high burden of mental health hospitalizations [207] 19) weight gain - in patients receiving metformin, daily liraglutide associated with lowest risk of weight gain & glimepiride the highest [272] Management: === new-onset diabetes mellitus type 2 === 1) insulin for most patients with type 2 diabetes who present initially with blood glucose >= 300 mg/dL [155] - insulin for 2-3 weeks if HgbA1c > 8.5% prior to switching to oral hypoglycemic(s) [287] 2) 5 mg saxagliptin plus 2000 mg metformin (oral) for patients with blood glucose 300-450 mg/dL, without ketoacidosis or symptoms of hyperosmolality [155] 3) screen for diabetic retinopathy at the time of diagnosis [182] 4) assess glycemic control every 3 months until target reached, then subsequently every 6 months [3] === goals of glycemic control === 1) glycemic targets & glucose-lowering treatments should be tailored to the individual patient [78] a) self monitoring of blood glucose for patients using mulitple daily injections of insulin or continuous cutaneous insulin infusion b) postprandial blood glucose for patients with at-goal preprandial blood glucose but hemoglobin A1c not at goal c) overnight blood glucose to detect hypoglycemia or dawn phenomenon d) individualized glycemic control may reduce healthcare costs - cost savings mostly from lower medication costs [184] e) quality of life marginally better with individualized glycemic control [184] f) early intensive glycemic control lowers 20 year mortality [279] g) avoidance of hypoglycemia top priority 2) goal of hemoglobin A1c a) Hgb A1c goal of 7%-8% for most patients [189] - lower targets do not reduce mortality or CV events but do increase risk of hypoglycemia [189] - American Diabetes Association (ADA) - < 7% healthy young adults - < 7.5% healthy older adults - older adults with with multiple chronic illnesses - < 8% complex/intermediate - < 8.5% very complex/poor health categories [273] - no specific target for frail elderly with limited life expectancy - American Geriatrics Society - target HbA1c goal between 7.5% & 8% for older adults [258] - higher target between 8% & 9% for those with multiple comorbidities, poor health, & limited life expectancy. [258] b) Hgb A1c goal of <= 7.0% not evidence-based [51] - may not diminish risk of retinopathy & nephropathy, neuropathy [43] - may not diminish risk of cardiovascular disease [43] - harm from hypoglycemia may outweigh benefit [51] - tight glycemic control (blood glucose 80-110 mg/dL) is not associated with improved outcomes & may increase mortality [3] - see glycemic control c) Hgb A1c goal <= 6.5% may increase mortality d) U-shaped mortality curve with respect to hemoglobin A1c; HbA1c of 6.4% & HbA1c of 10.6% with significantly higher mortality rates than HbA1c of 7.5% [56] e) dependent elderly with HbA1c of 8-9% have better functional outcomes at 2 years than elderly with HbA1c of 7-8% [88] f) see ACCORD trial, ADVANCE trial, UKPD study, VADT trial 3) tight glycemic control may do more harm than benefit; - increases risk of severe hypoglycemia [51] - poor outcomes with hypoglycemia, including death, heart disease, falls, & dementia [137] - intensive glucose control reduces non-fatal myocardial infarction, but not 5-year mortality [53] - tight glycemic control may diminish cardiovascular events in diabetics with few comorbidities, but not those with substantial comorbidities [54,55] - tight glycemic control may prevent or delay progression of diabetic retinopathy [3] - benefits of tight glycemic control persist after treatment ends only if HgbA1c remains low [216] 4) pharmaceutical therapy (see pharmaceutical agents below) - metformin is the initial drug of choice [180] - unless comorbidity predisposing to lactic acidosis (alcohol abuse) - dual therapy should be considered for asymptomatic patients with HbA1c >=9% [169] - sulfonylurea recommended add on [199] in low resource settings (WHO) - insulin recommended if metformin + sulfonylurea inadequate [199] (WHO) - liraglutide recommended as add on in obese patient [3] - insulin may be advisable for symptomatic patients or those with HbA1c of >=10% or greater or blood glucose of >= 300 mg/dL [169] 5) unless using multiple daily insulin injections, patients should avoid self testing of blood glucose a) goal of preprandial glucose 70-130 mg/dL [3] - may increase risk of severe hypoglycemia [51,56] b) goal of 1-2 hour postprandial glucose < 180 mg/dL [3] 6) patients with severe hyperglycemia well enough to go home do not benefit from more intensive glycemic control [166] === diet === 1) most important management strategy in type 2 diabetes 2) calorie restriction 3) for many patients, diet control is more optimism than science [19] 4) Mediterranean diet [180] a) improves glycemic control in new onset type-2 diabetes [52] b)reduces cardiovascular complications in patients with type-2 diabetes, including those with 'TT' variant of the TCF7L2 gene (high-risk polymorphism) [109] 5) legumes may improve glycemic control [91] 6) increased consumption of vegetables, whole grains, & soluble & insoluble fiber [121] 7) plant-based diet associated with improvement in insulin sensitivity glycemic control [121] 8) polyunsaturated fats lower mortality (RR=0.7) [221] - animal fats increase mortality (RR=1.2) [221] 9) weight-loss intervention in primary care may lead to remission [181] 10) low glycemic index diet of no benefit in reducing cardiovascular risk [134] 11) coffee & green tea may reduce mortality; effects may be additive [234] 12) intensive lifestyle intervention in obese patients including diet & exercise achieving 10% reduction in body weight within one year should result in reduced use of prescription diabetes medications [260] === regular exercise === 1) at least 150 minutes of physical activity every week [164] 2) combination of aerobic exercise & resistance training better than either alone [62] 3) no more than 2 consecutive days without activity [164] 4) exercise capacity is associated with increased survival [63] 5) 2-3 days/week of flexibility or balance training, such as tai chi or yoga for older adults with diabetes [164] 6) cycling lowers mortality by 25% [242] 7) exercise may be less important than diet [69] 8) take a break from prolonged sitting every 30 minutes [164] - limit sitting to < 90 minutes a stretch [135] - breaking up prolonged sitting with standing or walking may improve glycemic control [154] 9) precautions a) check fasting glucose prior to vigorous exercise b) rapidly absorbed carbohydrate prior to extended exercise if glucose is low c) avoid exercise within 4 h of regular insulin d) avoid jogging/ running if neuropathy or peripheral vascular disease is present e) avoid resistance training if retinopathy is present due to risk of ocular hemorrhage === pharmaceutical agents - hypoglycemic agents === 1) indications: - when diet, exercise, & weight loss fail to improve hyperglycemia [73] 2) use oral combination therapy early a) do not push monotherapy to maximum dose before adding second agent [3] b) no combination therapy is recommended over another [73] c) allowing patient to choose 2nd or 3rd line agent may be associated with better outcomes than choosing for the patient [254] 3) metformin (Glucophage) a) initial drug of choice [3,22,33,73,78,160,167,169,180] - unless comorbidity predisposing to lactic acidosis (alcohol abuse) b) start 500 mg PO BID or 850 mg PO TID c) optimal dose: 1000 mg BID d) may be used in combination with orlistat e) useful for overweight patients [8] f) do not use if eGFR < 30 ml/min/1.73 m2 - do not start if eGFR < 45 ml/min/1.73 m2 - formerly do not use if serum creatinine >= 1.5 mg/dL g) 10% lower risk of cancer relative to sulfonylurea [74] h) better cardiovascular outcomes relative to glipizide [102] - even in patients with stage 3 renal failure [224] i) dose-dependent reduction in risk of dementia [266] - higher daily dose & cumulative dose with greater risk reduction [266] - discontinuing metformin is associated with an increased risk of dementia [267] j) lower 5 year mortality than sulfonylurea even with GFR as low as 30 mL/min/1.73 m2 (absolute risk reduction 12/1000 patient years or less, > for lower GFR) [190] k) choice of add on when metformin alone is insufficient - not clear [86,167] - dual therapy should be considered for asymptomatic patients with HbA1c >=9% [169] - American College of Physicans (ACP) recommends adding an SGLT-2 inhibitor or a GLP-1 agonist to metformin [276] - add an SGLT-2 inhibitor to reduce risk for all-cause mortality, major cardiovascular events, chronic kidney disease & hospitalization due to congestive heart failure - add aGLP-1 agonist to reduce the risk for all-cause mortality, major cardiovascular events & stroke [275] - ACP recommends not adding a DPP-4 inhibitor to metformin [276] - American Diabetes Association recommends add on agent with proven cardiovascular benefit in patients with cardiovascular disease [182] - liraglutide (Victoza), empagliflozin (Jardiance) or other SGLT2 inhibitor may be acceptable for overweight patients [185] - flozins increase risk of yeast infection [3] - semaglutide improves HgbA1c more than canagliflozin 1.5 vs 1.0% [225] or empagliflozin as add on to metformin [235] - semaglutide also associated with more weight loss (5.3 vs 4.2 kg) - no dosage adjustment for renal failure with once weekly glutide - hypoglycemic agent of choice (if not insulin) in patients with CKD4 [260] - lorcaserin (Belviq) may be useful in overweight patients - add on sulfonylurea - superior to replacing metformin with sulfonylurea [195] - recommended by WHO in low resource settings - associated with weight gain - insulin may be advisable for symptomatic patients or those with HbA1c of >=10% or blood glucose of >= 300 mg/dL [169] - addition of insulin results in 44% increase in all-cause mortality relative to addition of sulfonylurea [125] - insulin, GLP-1 receptor agonists, sulfonylureas, & DPP-4 inhibitors as add ons to metformin with similar outcomes [252] l) patients started on 1st-line hypoglycemic agents other than metformin are more likely to require additional treatment [130] 4) sulfonylureas should be relegated to 3rd line agents [26] a) avoid in patients with alcohol abuse due to risk of hypoglycemia [260] b) recommended add on to metformin if metformin alone inadequate in low resouce settings [199] (WHO) - addition of sulfonylurea to metformin associated with 44% lower mortality than addition of insulin [125] - associated with weight gain [3] c) glipizide (Glucatrol) preferred sulfonyurea in the elderly - sulfonylureas should be avoided in elderly [211] d) associated with greater cardiovascular risk than metformin [94] e) for type-2 diabetes not controlled by metformin + a sulfonylurea, no add-on drug has an obvious advantage over another [67] f) metformin & SGLT2 inhibitors associated with a reduced risk of all-cause mortality compared with sulfonylureas [239] 5) acarbose (Precose) - inhibits alpha glucosidase - safer add-on to metformin than sulfonylurea [201] 6) thiazolidinediones (glitazones) a) may be used as 1st line agents [22,33] b) may diminish progression of atherosclerosis relative to sulfonylureas [34] c) avoid in patients with heart failure, CAD, or bladder cancer [93] d) avoid in patients with osteopenia or osteoporosis [260] - bone loss & increased risk of bone fracture (lumbar spine & hip) - effects greater in women than in men - see pharmaceutical agents that cause bone loss e) incidence of cardiovascular events, cardiovascular mortality, heart failure, bladder cancer, or fracture similar for pioglitazone vs sufonylurea as add on therapy to metformin [178] f) pioglitazone associated with reduced risk of dementia vs non-use (RR=0.84) - risk of dementia reduction greater among patients with a history of ischemic heart disease or stroke before diabetes onset (RR=0.46) [257] 7) gliptins (DPP-4 inhibitors): - sitagliptin, saxagliptin, vildagliptin - linagliptin (Tradjenta) in the elderly with renal insufficiency [93] - gliptin as add on therapy to metformin superior to sulfonylurea [144] - 2% lower mortality, 1% lower risk of stroke - no difference in risk of MI or hospitalization for heart failure [144] - add on to SGLT-2 inhibitor (flozin) but not incretin mimetic (GLP-1 agonist) [232] - gliptins may lower regional beta-amyloid burden in temporal lobes & parietal lobes & slow measures of cognitive decline more than other hypoglycemics [241] - sitagliptin hypoglycemic agent of choice in patient with alcohol abuse [260] - see disease interactions 8) when combined with metformin, gliptins & glitazones are associated with lower risk cardiovascular disease, heart failure & all-cause mortality [163] 9) glitazars introduced in 2005 10) repaglinide & nateglinide (avoid in elderly & with alcohol abuse) [211] 11) incretin mimetics (GLP-1 agonists) - indicated for established cardiovascular disease or high risk, kidney disease - beneficial for reduced ejection fraction or chronic kidney disease [3,228] - recommendation without regard to HgbA1c or HgbA1c target [228] - exenatide (Byetta) may also promote weight reduction [30] - weekly exenatide does not diminish cardiovascular risk [179] - incretin mimetics liraglutide & dulaglutide may reduce cardiovascular mortality & all-cause mortality in high-risk patients [217,275] - may be use in combination with metformin, sulfonylurea or insulin [66] - GLP-1 agonist + insulin superior [128] - linked with renal failure in elderly [93] - GLP-1 agonist preferred over insulin if injectable needed [206] - semaglutide may diminish HgbA1c as add on to metformin > dulaglutide by 0.4% & > sitagliptin by 0.3-0.5% [214,215] - dulaglutide may attenuate cognitive decline (14%) in diabetics with additional cardiovascular risk factors [229] - no dosage adjustment for renal failure with weekly glutide 12) SGLT-2 inhibitors (flozins) - starting flozin before metformin not indicated [250] - flozins may be more effective as 2nd line treatment than sulfonylureas or DPP-4 inhibitors [280] - indicated for established cardiovascular disease or high risk [3] - beneficial for reduced ejection fraction or chronic kidney disease [228] - recommendation without regard to HgbA1c or HgbA1c target [228] - may be beneficial for foot ulcers & risk for foot amputation [228] - canagliflozin, dapagliflozin, empagliflozin, ertugliflozin - option as monotherapy when metformin, sulfonylurea, & pioglitazone contraindicated [249] - a gliptin would otherwise be prescribed [NICE] - canagliflozin may reduce risk of hospitalization for heart failure relative to DPP-4 inhibitors, sulfonyureas, or GLP-1-receptor agonists [186] - flozins lowest in cardiovascular mortality < GLP-1 agonists < DPP-4 inhibitors (no mention of metformin) [193] - adding incretin mimetic (GLP-1 agonist to SGLT-2 inhibitor (flozin) improves glycemic control in poorly controlled type 2 diabetes [209] - useful in patients where weight loss or minimizing weight gain is important [232] - SGLT-2 inhibitors slow progression of diabetic nephropathy [255] - SGLT-2 inhibitors with marginal outcome advantage vs GLP-1 agonists [245] 13) insulin a) long-acting insulin for symptomatic patients, HbA1c of >=10%, or blood glucose >= 300 mg/dL [169] - convert later to oral hypoglycemic (if feasible) - taper insulin for episodes of hypoglycemia [260] - for elderly with multiple comorbidities, relax glycemic control - once daily long-acting insulin regardless of HgbA1c [182] b) evening dose of NPH, glargine or degludec added to oral hypoglycemic agent(s) [13] 1] stop sulfonylureas & meglitinides when starting insulin [240] 2] start 10 units QHS 3] target morning glucose < 150 mg/dL 80-120 mg/dL [3] 4] premeal blood glucose target 80-130 mg/dL [135] 5] glargine may be associated with less hypoglycemia than NPH - especially in elderly [236] 6] degludec may be associated with less hypglycemia than glargine (RR=0.70) [176] 7] continuing metformin in patients who require insulin is associated with better glycemic control, but not all-cause or cardiovascular mortality [79] 8] if hypoglycemia with morning blood glucose < 70 mg/dL, decrease evening insulin by 4 units or 10% which ever is greater [240] c) addition of glargine or rosiglitazone to combination therapy of metformin plus sulfonylurea of similar initial efficacy [28] d) insulin glargine given early in the course of DM2 does not diminish risk of cardiovascular events [83] e) avoid insulin if possible in non-hospitalized elderly [117] & in patients with alcohol abuse [260] f) insulin plus metformin associated with higher mortality than sulfonylurea plus metformin (mean age = 60 years; mean HgbA1c = 8.1%) [125] g) insulin pump associated with lower HgbA1c than multiple daily insulin injections [127] - if patient is non-compliant with multiple daily insulin infections, medical compliance is unlikely to increase with an insulin pump [3] h) addition of weekly GLP-1 receptor agonist to evening glargine or degludec results in lower hemoglobin A1c & body weight & less hypoglcemia than addition of prandial insulin lispro [268] - addition of liraglutide to insulin in patients with long-standing type 2 diabetes improves glycemic control [146] - addition of weekly tirzepatide to evening glargine in patients with inadequately controlled type 2 diabetes lowerb hemoglobin A1c & body weight & rusults in less hypoglcemia than addition of prandial insulin lispro [268] - degludec/liraglutide may afford better glycemic control than glargine [150] i) glutide or flozin with basal long-acting insulin with comparable glycemic control & less hypoglycemia than basal long-acting insulin + premeal insulin [238] j) may be able to discontinue insulin in ketosis-prone type-2 diabetics presenting with diabetic ketoacidosis [149] k) pramlintide may reduce insulin requirements l) if insulin requirement > 200 units/day, switch to concentrated form of insulin, U-500 regular insulin (most insulins provided at 100 units/mL (U-100) [260] m) insulin icodec once weekly insulin investigational (not yet FDA-approved) 14) rimonabant (Acomplia) may be of benefit 15) bromocriptine (Cycloset) FDA-approved 2009 [57] 16) cinnamon probably of no benefit [18] 17) salsalate lowers plasma glucose & Hgb A1C (0.37%) but increases LDL cholesterol, body weight & urine albumin [105] 18) sodium phenylbutyrate improves peripheral insulin sensitivity & glucose oxidation [246] 19) comparison of 1st line agents [152,193] a) if high cardiovascular risk, SGLT2 inhibitor or GLP-1 receptor agonist to reduce CV risk (ACC) [231] b) metformin monotherapy associated with lesser cardiovascular mortality than sulfonylurea monotherapy c) most oral hypoglycemics have similar effects on HbA1c; however, DPP-4 inhibitors are not as effective as metformin or sulfonylureas d) SGLT-2 inhibitors lower weight more than metformin, which lowers weight more than DPP-4 inhibitors - consider SGLT2 inhibitor for patient with diabetic nephropathy & stage G3 chronic renal failure [216] e) sulfonylureas associated with risk for severe hypoglycemia, metformin & incretin mimetics with GI side effects, & SGLT-2 inhibitors with genital mycoses f) flozins lowest in cardiovascular mortality < GLP-1 agonists < DPP-4 inhibitors (no mention of metformin) [193] g) incretin mimetics may attenuate progression of albuminuria & lower risks of cardiovascular events [216] === control of risk factors (also see diabetes mellitus complication) === 1) diabetic nephropathy a) ACE inhibitor or ARB b) dapagliflozin attenuates progression of diabetic nephropathy [212] c) neither Vitamin D or omega-3 fatty acid supplementation or both preserve renal function [228] d) semaglutide reduces risk of renal complications & cardiovascular mortality in patients with diabetic nephropathy [277] 2) dyslipidemia a) goals somewhat controversial 1] LDL cholesterol < 70 mg/dL; < 55 mg/dL high risk [255] 2] HDL cholesterol > 40 mg/dL (men); > 50 mg/dL (women) 3] serum triglycerides < 150 mg/dL is unfounded - no benefit of fibrate (see ACCORD trial, Field study) 4] fenofibrate lowers serum urate & lowers risk for gout [188] 5] ethyl icosapentate (Vascepa) may be considered if LDL cholesterol is controlled with statin [212] 6] atorvastatin, rosuvastatin & simvastatin best statins for lowering non-HDL cholesterol in patients with diabetes mellitus [248] b) AHA/ACC guidelines recommend moderate dose statin for adults 40-75 years ASCVD calculated cardiovascular risk < 7.5% - even if cholesterol levels are at target [12,17,20,31] - moderate-dose statin: (atorvastatin 10-20 mg daily, rosuvastatin 5-10 mg daily, simvastatin 20-40 mg daily, pravastatin 40-80 mg daily) c) USPSTF recommends moderate-high dose statin for adults 40-75 years of age without cardiovascular disease & at least one additional risk factor & ASCVD calculated cardiovascular risk of >= 10% [3,92,141] d) high-intensity statin therapy (atorvastatin, rosuvastatin) - known cardiovascular disease (secondary prevention) - AHA/ACC guidelines recommend moderate dose statin for adults 40-75 years ASCVD calculated cardiovascular risk >= 7.5% - LDL cholesterol > 190 mg/dL - 10 year history of type 2 diabetes & diabetes complication [3] - ezetimibe 1st add on to high-intensity statin - PCSK9 inhibitor recommended if on maximum statin & ezetimibe therapy & LDL-cholesterol > 130 mg/dL [3] e) former & other recommendations - statin treatment based on individual risk rather than LDL cholesterol [135] - moderate-dose statin if 10-year cardiovascular risk is >= 7.5% [3,244] - formerly high-dose statin recommended [132,141] - other statins for patients >= 40 years of age with 10 year risk of cardiovascular event < 7.5% [3] f) see use of HMG CoA reductase inhibitors (statins) ... 3) cardiovascular disease a) control of dyslipidemia (see above) b) diet & exercise (see above) c) aspirin 81 mg QD (75-162 mg) 1] recommended for men > 50 & women > 60 years with at least one cardiovascular risk factor without contraindications [3,59,60,92] 2] men or women 50-59 years of age with cardiovascular risk >= 10% regardless of diabetes mellitus [3] (USPSTF) 3] optional for elderly diabetics without risk factors 4] recommended for younger patients at high risk [60] 5] may not diminish cardiovascular risk [41] 6] aspirin reduces risk of serious vascular events (RR=0.88) but increases risk of major bleeding (RR=1.3) [197] d) beta-blockers may mask symptoms of hypoglycemia - beta-blockers not associated with increased mortality when used in combination with intensive glycemic control [165] - beta-blockers may increase mortality in patients with diabetes mellitus [192] e) telmisartan & valsartan may reduce cardiovascular risk (15%), but other ARBs may not [106] f) GLP-1 receptor agonists (incretin mimetics) liraglutide & dulaglutide may reduce cardiovascular mortality & all-cause mortality in high-risk patients [217] g) American College of Cardiology & American College of Physicians recommend SGLT2 inhibitors & GLP-1 receptor agonists for diabetics with cardiovascular disease [204,231,232] - dapagliflozin associated with reduced heart failure hospitalization [212] h) no significant difference in mortality or major cardiovascular events between: 1] patients undergoing revascularization & those undergoing medical therapy [50] 2] strategies of insulin sensitization (mostly metformin &/or thiazolidinedione) vs insulin provision [50] 3] pioglitazone vs sulfonylurea as add on therapy to metformin [178] i) no benefit of omega-3 fatty acids [84,198] - fish oil supplementation & higher plasma n-3 PUFA levels, especially DHA, associated with lower risks of macrovascular complications & microvascular complications in patients with type 2 diabetes [282] j) no advantage of intensive lifestyle intervention over usual diabetes care in reducing cardiovascular risks in overweight diabetics [104] k) smoking cessation may adversely affect glycemic control [139] l) patients can achieve cardiovascular risk similar to non-diabetics through control of HbgA1c, hypertension, albuminuria, smoking, & dyslipidemia (elevated LDL cholesterol) [196] m) CABG associated with improved outcomes in diabetics undergoing revascularization [3] 4) obesity a) weight reduction - weight-loss intervention in primary care may lead to type 2 diabetes remission [181] - overweight boys who achieve a healthy BMI no longer at increased risk for type 2 diabetes as adults [191] - lorcaserin (Belviq) may promote weight loss & slow progression to type 2 diabetes & promote remission of type 2 diabetes [202] - liraglutide is appropriate add on to metformin in obese patients [3] b) heavier patients do not live longer [114] c) bariatric surgery (see bariatric surgery) - indications [153] - BMI >= 40 - BMI >= 35 with poor glycemic control [153] - BMI thresholds for Asians should be reduced by 2.5 kg/m2 [153] - improves glycemic control in obese patients [76] - lowers hemoglobin A1c at 7 years (mean 1.4%) & 12 years (mean 1.1%) 274] - outperforms medical therapy in obese patients [77,124,126] - reduces risk of microvascular complications by 50% & macrovascular complications by 30% [126] - 70% of patients in remission at 2 years; 30% at 15 years [126] - better glycemic control than intensive medical therapy in obese patients, even after 5 years [168] - may improve health in patients with a BMI of >= 35 who have an obesity-related condition [141] - risk vs benefit in non-morbidly obese patients uncertain [100] - reduces risk of type 2 diabetes (RR-0.2) - increases likelihood of discontinuing diabetes meds [187] - gastric bypass is superior to gastric banding or sleeve gastrectomy for remission of type 2 diabetes & metabolic benefits [260] 5) hypertension (also see hypertension & diabetes) a) ACE inhibitor or ARB if albuminuria &/or hypertension 1st line [92,255] - ACE inhibitors reduce proteinuria (diabetic nephropathy) - ACE inhibitors of no benefit for microalbuminuria [92] b) use of ACE inhibitors or ARBs not recommended for patients with normal blood pressure & urine albumin/creatinine < 30 mg/g & eGFR > 60 mL/min/1.73 m2 [3] c) angiotensin II receptor antagonists do NOT reduce proteinuria (see diabetic nephropathy) d) thiazide diuretics recommended as 1st line agents [11] - synergistic effect when used with ACE inhibitor or ARB - avoid in patients with history of gout - caution: may worsen glycemic control e) dihydropyridine calcium channel blocker f) carvedilol 1] less tendency to cause hyperglycemia & dyslipidemia than other beta blockers 2] may reduce risk of microalbuminuria [23] g) target BP of < 130/80 (2023 ADA, ACC, AHA) is the current guideline 1] previously not supported by data 2] prior target BP > 140/90 [61,135,182] (2018 ADA) 3] stricter guidelines < 120/70 mmg Hg [7] not widely accepted 4] < 135/80 mm Hg (American College of Physicians [11]) - guideline withdrawn in 2009 5] no benefit to target systolic blood pressure lower than 2018 ADA standard therapy (< 140 mm Hg) see ACCORD trial - target BP of < 130/80 (2023 ADA) 6] INVEST trial results similar to ACCORD trial [61] 7] systolic blood pressure < 120 mm Hg associated with lower risk for cardiovascular events & cardiovascular mortality but elevated risk for heart failure & all-cause mortality [162] 8] see hypertension & diabetes h) mortality, cardiovascular events & renal failure similar with ACE inhibitors, ARBs, calcium-channel blockers, thiazide diuretics, & beta-blockers [151] 6) diabetic retinopathy - comprehensive eye examination at the time of diagnosis - annual funduscopic examination 7) obstructive sleep anea - CPAP may improve glycemic control (see nasal CPAP) 8) pain from inflammatory disorders (osteoarthritis etc) - salsalate is an anti-inflammatory agent that lowers HgbA1c 9) periodontal disease - treatment of periodontal disease may improve glycemic control [116] 10) alcohol abuse - avoid medications that increase risk of lactic acidosis (metformin) or hypoglycemia (sulfonylurea, insulin, repaglinide) patients [260] 11) vaccinations: - hepatitis B vaccine - diabetics age 19-59 years ASAP after diagnosis [71] - diabetics age >= 60 years optional [71] === exacerbations/episodes of hyperglycemia === - rule out infection, especially urinary tract infection in the elderly === episodes of illness/hospitalization === 1) many hospitalized patients can be managed with insulin sliding scale alone [243] - use of insulin sliding scale alone not recommended [3] 2) therapy must be individualized a) stress from acute illness can cause hyperglycemia b) less food intake due to poor appetite or vomiting can cause hypoglycemia [96] 3) critically ill patients [3] a) initiate insulin infusion when plasma glucose exceeds 180-200 mg/dL b) target plasma glucose to 140-180 mg/dL with q1-2 hour bedside blood glucose monitor c) ICU patients target serum glucose is 140-180 mg/dL [180] 4) non-critically ill hospitalized patients who are eating - use basal & prandial subcutaneous insulin [180,269,270] - insulin recommended if serum glucose > 180 mg/dL [3] - target of 140-180 mg/dL [3 - adequate nutritional intake: basal + prandial + correction insulin - poor nutritional intake or NPO: basal + correction insulin - other agents in hospital setting do not have proven record of safety [3] - basal & prandial subcutaneous insulin + insulin sliding scale with thresholds of > 140 vs 260 mg/dL did not differ in hypoglycemia, severe hyperglycemia, or % of blood glucose in target range of 70-180 mg/dL [253] 5) stop metformin if risk of dehydration, i.e. vomiting or diarrhea, due to concern for lactic acidosis [96] - restart when vomiting &/or diarrhea have stopped & eating & drinking again [96] 6) if not eating, consider holding sulfonylurea [96] 7) do NOT stop basal (long-acting) insulin [96] - may need to lower the dose of basal insulin if not eating [96] - fast-acting insulin may be needed for episodes of hyperglycemia 8) check blood glucose frequently [96] === assessment of disease progression === 1) hemoglobin A1c every 2-3 months 2) urinary albumin/creatinine ratio annually 3) fasting lipid panel annually 4) eye exam a) ophthalmologic evaluation at the time of diagnosis [182] b) funduscopic examination every 6-12 months 5) foot care a) inspect feet for deformity, ulceration, vascular insufficiency every 6 months b) deep tendon reflex at ankles c) vibratory & light pressure thresholds in feet 6) routine cardiac stress testing not indicated [3] === patient education === 1) finger stick capillary glucose technique - preprandial target of 80-120 mg/dL - routine self glucose monitoring does not improve outcomes [175] 2) factors influencing blood sugar 3) signs & symptoms of hypoglycemia 4) glucagon IM if found unresponsive (friends & family) 5) foot care 6) wine 1 glass/day with dinner may diminish fasting blood glucose [38] 7) group sessions ineffective [80] 8) peer mentoring lowers HbA1c levels by ~1% [81] 9) 4 key times when clinicians should assess the need for patient education [140] - at diagnosis - yearly after diagnosis - when complications occur (i.e. stroke, vision impairment) - during transitions in care (i.e., due to new living situations or insurance coverage) [140] 10) diabetes & medication education prior to hospital discharge [180] === life style intervention === 1) intensive therapy has its limits (see ACCORD trial, ADVANCE trial & UKPDS data [40]) 2) effect of intensive lifestyle intervention on remission of type 2 diabetes is modest [148] 3) intensive lifestyle intervention to help patients lose weight does not lower cardiovascular risk [90] 4) lifestyle modification for prevention [24,110] - weight reduction & exercise most effective means [95] 5) intensive lifestyle intervention to reduce cardiovascular risks in overweight people with type 2 diabetes finds no advantage over usual diabetes care 6) lifestyle interventions may not benefit patients with long-standing diabetes mellitus type 2 7) smoking cessation may adversely affect glycemic control [139] 8) intensive lifestyle intervention in obese patients including diet & exercise achieving 10% reduction in body weight within one year should result in reduced use of prescription diabetes medications [260] === herbal remedies === - apple cider vinegar & fenugreek seeds are the most effective herbal agents to reduce fasting blood glucose & hemoglobin A1c [262] - apple cider vinegar is the most effective [262] - cinnamon & curcumin (turmeric) also reduce fasting blood glucose - ginger & saffron do not [262] === glucose monitoring === - self-monitoring of blood glucose fails to lower HgbA1c - capillary blood glucose of little to no benefit in patients not taking insulin [122,156] - continuous glucose monitoring - may benefit patients taking insulin [177] - may reduce hypoglycemia in hospitalized patients taking insulin [233] - d-Nav Insulin Guidance System measures, records, & analyzes scheduled fingerstick blood glucose levels & uses an algorithm to recommend insulin dose adjustments directly to patients [210] === other including autologous stem cell transplantation === - screening for diabetes mellitus in high-risk individuals [10] - also see fasting with diabetes mellitus - guidelines for managing type 2 diabetes in the elderly [93] - functional assessment/cognitive assessment for multiple episodes of hypoglycemia in elderly who had been stable on insulin-containing regimens for years [156] - reprogrammed autologous stem cells transformed into insulin-producing islet cells transplanted into the liver of a man with type-2 diabetes [283] - endoscopic catheter ablation of duodenal mucosa with electroporation, allegedly enhances sensitivity to endogenous insulin [284] - recellularization via electroporation therapy (ReCET) Notes: - multidisciplinary, intensive management improves outcomes [9,10] - clinically relevant threshold of 0.5% [75] - quality measures should consider hypoglycemia [117] - primary care providers rarely reduce hypoglycemic treatment for older patients with diabetes, even if they achieve recommended targets [145] - ~50% of 600 VA primary care providers said they would not be concerned about adverse effects of tight glucose control for an older patient at high risk for hypoglycemia and an HbA1c level of 6.5% [145] - nurse practitioners & physician assistants provide non-inferior primary care vs physicians [203] - patients frequently check their blood glucose levels multiple times daily, even when guidelines suggest otherwise [205] - insulin use highest & discontinuation rates lowest among patients in poorest health [226] - unnecessarily aggressive management may result in more harm than benefit [226] Comparative biology: - injection of FGF-1 into the cerebral ventricles of mice or rats with type 2 diabetes conferred glucose control for at least 17 weeks

Interactions

disease interactions

Related

blood pressure & hypertension in diabetes diabetes mellitus complication diabetics who become pregnant fasting with diabetes mellitus glycemic control hyperglycemia insulin resistance risk factors for coronary artery disease in patients with diabetes mellitus type-2 risk factors for diabetes mellitus type 2 & risk factor reduction screening for diabetes mellitus

Useful

dietary therapy for diabetes mellitus hypoglycemic agent use of HMG CoA reductase inhibitors (statins) in patients with diabetes mellitus

Specific

diabetes in the elderly diabetes mellitus, non-insulin-dependent, 5 (NIDDM5) insulin-resistant diabetes mellitus with acanthosis nigricans leprechaunism (Donohue syndrome) Rabson-Mendenhall syndrome (Mendenhall syndrome) youth-onset type 2 diabetes; mature onset diabetes of the young (MODY)

General

diabetes mellitus

Database Correlations

OMIM correlations MORBIDMAP correlations

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 629-31
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 54
  3. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2021. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. Journal Watch 21(3):21, 2001 Mogensen CE et al Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. BMJ 321:1440, 2000 PMID: 11110735
  5. Genova, A, UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  6. Lee, A. UCLA Multicampus Program in Geriatrics & Gerontology, weekly lecture series, Feb 14, 2002
  7. Abbasi J For Patients With Type 2 Diabetes, What's the Best Target Hemoglobin A1C? JAMA. Published online May 30, 2018 PMID: 29847622 https://jamanetwork.com/journals/jama/fullarticle/2683543
  8. Journal Watch 22(17):132, 2002 Miles JM et al Effect of orlistat in overweight and obese patients with type 2 diabetes treated with metformin. Diabetes Care 25:1123, 2002 PMID: 12087008
  9. Journal Watch 23(5):37, 2003 Gaede P et al Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 348:383, 2003 PMID: 12556541
  10. Prescriber's Letter 10(3):16 2003 - Screening for Type 2 Diabetes Mellitus in Adults Detail-Document#: 190321 - Summary of 2003 American Diabetes Association Recommendations Detail-Document#: 190307 (subscription needed) http://www.prescribersletter.com
  11. Journal Watch 23(10):78, 2003 Berl T et al, Cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial of patients with type 2 diabetes and overt nephropathy. Ann Intern Med 138(Apr 1):542, 2003 PMID: 12667024 http://www.annals.org/issues/v138n7/full/200304010-00017.html - Vijan S & Hayward RA, Treatment of hypertension in type 2 diabetes mellitus: blood pressure goals, choice of agents, and setting priorities in diabetes care. Ann Intern Med 138(Apr 1):593, 2003 PMID: 12667032 http://www.annals.org/issues/v138n7/full/200304010-00018.html
  12. Statin Therapy for Patients with Diabetes Prescriber's Letter 10(7):38 2003 Detail-Document#: 190702 (subscription needed) http://www.prescribersletter.com
  13. Journal Watch 23(23):185, 2003 Riddle MC et al The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care 26:3080, 2003 PMID: 14578243
  14. Journal Watch 24(4):30, 2004 Salazar-Martinez E et al Coffee consumption and risk for type 2 diabetes mellitus. Ann Intern Med 140:1, 2004 PMID: 14706966
  15. Brown AF, Mangione CM, Saliba D et al Guidelines for Improving the Care of the Older Person with Diabetes Mellitus, JAGS 51:S265-280, 2003 PMID: 12694461 - American Geriatrics Society. Moreno G et al Guidelines abstracted from the American Geriatrics Society Guidelines for Improving the Care of Older Adults with Diabetes Mellitus: 2013 update. J Am Geriatr Soc. 2013 Nov;61(11):2020-6. PMID: 24219204 Free PMC Article
  16. Journal Watch 24(11):90-91, 2004 Quinones MJ, Hernandez-Pampaloni M, Schelbert H, Bulnes-Enriquez I, Jimenez X, Hernandez G, De La Rosa R, Chon Y, Yang H, Nicholas SB, Modilevsky T, Yu K, Van Herle K, Castellani LW, Elashoff R, Hsueh WA. Coronary vasomotor abnormalities in insulin-resistant individuals. Ann Intern Med. 2004 May 4;140(9):700-8. PMID: 15126253
  17. Lipid Control in Diabetes: Review of Clinical Practice Guidelines Prescriber's Letter 11(6):35 2004 Detail-Document#: 200612 (subscription needed) http://www.prescribersletter.com
  18. Prescriber's Letter 11(8): 2004 Cinnamon for Patients with Type 2 Diabetes Detail-Document#: 200803 (subscription needed) http://www.prescribersletter.com - Prescriber's Letter 15(3): 2008 Should Patients Use Cinnamon for Type 2 diabetes? Detail-Document#: 240303 - Khan A et al, Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003, 26:3215 PMID: 14633804 - Baker WL et al, Effect of cinnamon on glucose control and lipid parameters. Diabetes Care 2008, 31:41 PMID: 17909085
  19. Journal Watch 24(18):145, 2004 Hippisley-Cox J, Pringle M. Prevalence, care, and outcomes for patients with diet- controlled diabetes in general practice: cross sectional survey. Lancet. 2004 Jul 31;364(9432):423-8. PMID: 15288740
  20. Journal Watch 24(19):149, 2004 Colhoun HM, Betteridge DJ, Durrington PN, Hitman GA, Neil HA, Livingstone SJ, Thomason MJ, Mackness MI, Charlton-Menys V, Fuller JH; CARDS investigators. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004 Aug 21;364(9435):685-96. PMID: 15325833
  21. Prescriber's Letter 12(1): 2005 Carvedilol: is it a Better Choice in Patients with Diabetes? Detail-Document#: 210102 (subscription needed) http://www.prescribersletter.com
  22. Journal Watch 25(3):24, 2005 Schernthaner G, Matthews DR, Charbonnel B, Hanefeld M, Brunetti P; Quartet [corrected] Study Group. Efficacy and safety of pioglitazone versus metformin in patients with type 2 diabetes mellitus: a double-blind, randomized trial. J Clin Endocrinol Metab. 2004 Dec;89(12):6068-76. Erratum in: J Clin Endocrinol Metab. 2005 Feb;90(2):746. PMID: 15579760
  23. Internal Medicine News, April 15, 2005
  24. Prescriber's Letter 12(7): 2005 Evidence for Preventing Type 2 Diabetes Detail-Document#: 210707 (subscription needed) http://www.prescribersletter.com
  25. Tirosh A, Shai I, Tekes-Manova D, Israeli E, Pereg D, Shochat T, Kochba I, Rudich A; Israeli Diabetes Research Group. Normal fasting plasma glucose levels and type 2 diabetes in young men. N Engl J Med. 2005 Oct 6;353(14):1454-62. PMID: 16207847
  26. Dr. David S. H. Bell, University of Alabama at Birmingham, Canadian Medical Association Journal, January 17, 2006
  27. Centers for Disease Control
  28. Rosenstock J et al, Triple therapy in type 2 diabetes: Insulin glargine or rosiglitazone added to combination therapy of sulfonylurea plus metform in insulin-naive patients. Diabetes Care 2006; 29:554 PMID: 16505505
  29. Internal Medicine World Report vol 21, 2006
  30. Prescriber's Letter 13(5): 2006 Byetta (Exenatide) for Weight Loss Detail-Document#: 220506 (subscription needed) http://www.prescribersletter.com
  31. Costa J et al, Efficacy of lipid-lowering drug treatment of diabetic and non-diabetic patients, Meta-analysis of randomized controlled trials. (meta-analysis that did NOT include Field trial) BMJ 2006; 332:1115 PMID: 16585050 - Reckless JPD Diabetes and lipid lowering. Where are we? We're now sure that statins cut cardiovascular risks in type 2 diabetes. BMJ 2006; 332:1103 PMID: 16585050
  32. Prescriber's Letter 13(11): 2006 American Diabetes Association Treatment Algorithm for Type 2 Diabetes Treatment of Type 2 Diabetes Mellitus Detail-Document#: 221103 (subscription needed) http://www.prescribersletter.com - Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, Zinman B. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2006 Aug;29(8):1963-72. No abstract available. PMID: 16873813
  33. Kahn SE et al, Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med 2006, 355:2427 PMID: 17145742 - Nathan DM Thiazolidinediones for initial treatment of type 2 diabetes? N Engl J Med 2006, 355:2477 PMID: 17145743
  34. Mazzone T et al, Effect of pioglitazone compared with glimepiride on carotid intima-media thickness in type 2 diabetes: A randomized trial. JAMA 2006, 296:2572 PMID: 17101640
  35. Prescriber's Letter 14(1): 2007 Choosing Initial Monotherapy for Type 2 Diabetes: the ADOPT study Detail-Document#: 230104 (subscription needed) http://www.prescribersletter.com
  36. Prescriber's Letter 14(7): 2007 Stepwise Approach to Selecting Treatments for Type 2 Diabetes Detail-Document#: 230718 (subscription needed) http://www.prescribersletter.com
  37. Prescriber's Letter 14(9): 2007 Self-monitoring of blood glucose in patients with type 2 diabetes Detail-Document#: 230912 (subscription needed) http://www.prescribersletter.com
  38. Shai I et al, Glycemic effects of moderate alcohol intake among patients with type 2 diabetes: A muticenter, randomized, clinical intervention trial. Diabetes Care 2007, 30:3011 PMID: 17848609
  39. McCormack J, Greenhalgh T. Seeing what you want to see in randomised controlled trials: versions and perversions of UKPDS data. United Kingdom prospective diabetes study. BMJ. 2000 Jun 24;320(7251):1720-3. PMID: 10864554
  40. Prescriber's Letter 15(8): 2008 COMMENTARY: A1c: How Low Should You Go? GUIDELINES: ADA Position Statement on Standards of Medical Care in Diabetes - 2008 GUIDELINES: CDA Clinical Practice Guidelines on Monitoring Glycemic Control Detail-Document#: 240801 (subscription needed) http://www.prescribersletter.com
  41. Ogawa H et al, Low-Dose Aspirin for Primary Prevention of Atherosclerotic Events in Patients With Type 2 Diabetes JAMA. 2008 Nov 9. [Epub ahead of print] PMID: 18997198 http://jama.ama-assn.org/cgi/content/full/2008.623
  42. Prescriber's Letter 15(12): 2008 CHART: Stepwise Approach to Selecting Treatments for Type 2 Diabetes COMMENTARY: Updated Treatment Recommendations for Type 2 Diabetes CHART: Initiation and Adjustment of Insulin Regimens for Type 2 Diabetes GUIDELINES: 2008 ADA Consensus Statement on Management of Hyperglycemia in Type 2 Diabetes Detail-Document#: 241202 (subscription needed) http://www.prescribersletter.com
  43. Duckworth W et al for the VADT investigators Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes N Engl J Med 2008, December 17, 2008 PMID: 19092145
  44. Prescriber's Letter 16(2): 2009 COMMENTARY: Low-dose Aspirin Recommendations for Diabetes Patients GUIDELINES: Screening for Type 2 Diabetes Mellitus in Adults GUIDELINES: Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada Detail-Document#: 250204 (subscription needed) http://www.prescribersletter.com
  45. Prescriber's Letter 16(3): 2009 - Stepwise Approach to Selecting Treatments for Type 2 Diabetes - Initiation and Adjustment of Insulin Regimens for Type 2 Diabetes Detail-Document#: 250305 (subscription needed) http://www.prescribersletter.com
  46. Whitmer RA et al Hypoglycemic Episodes and Risk of Dementia in Older Patients With Type 2 Diabetes Mellitus JAMA 2009;301:1599-1601 PMID: 19366776
  47. Young LH et al Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes The DIAD Study: A Randomized Controlled Trial JAMA. 2009;301(15):1547-1555 PMID: 19366774
  48. Montori VM et al Glycemic control in type 2 diabetes: time for an evidence- based about face? Annals of Internal Medicine 2009 150(11) June 2 PMID: 19380837
  49. Leunissen RW et al Timing and Tempo of First-Year Rapid Growth in Relation to Cardiovascular and Metabolic Risk Profile in Early Adulthood. JAMA. 2009;301(21):2234-2242. PMID: 19491185
  50. Frye RL et al for The BARI 2D Study Group A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease N Engl J Med. 2009 Jun 11;360(24):2503-15 PMID: 19502645
  51. Meinert CL et al A study of the effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes: II. Mortality results. Diabetes 1970; 19:Suppl:789. PMID: 4926376 - Gerstein HC et al Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008 Jun 12; 358:2545 PMID: 18539917 http://dx.doi.org/10.1056/NEJMoa0802743 - Patel A et al Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008 Jun 12; 358:2560. PMID: 18539916 http://dx.doi.org/10.1056/NEJMoa0802987 - Duckworth W et al Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 2009 Jan 8; 360:129. PMID: 19092145 http://dx.doi.org/10.1056/NEJMoa0808431 - UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998 Sep 12; 352:837. PMID: 9742976 - Montori VM and Fernandez-Balsells M. Glycemic control in type 2 diabetes: Time for an evidence- based about-face? Ann Intern Med 2009 Jun 2; 150:803. PMID: 19380837 - Lehman R and Krumholz HM. Tight control of blood glucose in long standing type 2 diabetes. BMJ 2009 Apr 18; 338:901. PMID: 19264821 http://dx.doi.org/10.1136/bmj.b800 - Havas S. The ACCORD trial and control of blood glucose level in type 2 diabetes mellitus: Time to challenge conventional wisdom. Arch Intern Med 2009 Jan 26; 169:150. PMID: 19171811 - Haynes RB and Haynes GA. What does it take to put an ugly fact through the heart of a beautiful hypothesis? Evid Based Med 2009 Jun; 14:68. PMID: 19483017 http://content.nejm.org/cgi/content/full/NEJMoa0805796v1 - The NNT: Tight Glycemic Control for Type 2 Diabetes (Over Five Years) http://www.thennt.com/nnt/tight-glycemic-control-for-type-2-diabetes-over-5-years/ - Hemmingsen B, Lund SS, Gluud C et al Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2013 Nov 11;11:CD008143 PMID: 24214280
  52. Esposito K et al Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: A randomized trial. Ann Intern Med 2009 Sep 1; 151:306. PMID: 19721018
  53. Kelly TN et al. Systematic review: Glucose control and cardiovascular disease in type 2 diabetes. Ann Intern Med 2009 Sep 15; 151:394. PMID: 19620144
  54. Greenfield S et al Comorbidity Affects the Relationship Between Glycemic Control and Cardiovascular Outcomes in Diabetes. A Cohort Study Ann Intern Med December 15, 2009 151:854-860 PMID: 20008761 http://www.annals.org/content/151/12/854.abstract
  55. Nathan DM The Role of Glycemia Management in the Prevention of Cardiovascular Disease-Starting Over? Ann Intern Med December 15, 2009 151:888-889 PMID: 20008764 doi:10.1059/0003-4819-151-12-200912150-00010
  56. Currie CJ et al Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study Lancet. 2010 Feb 6;375(9713):438-40. Epub 2010 Jan 26. PMID: 20110122 doi:10.1016/S0140-6736(09)61969-3 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61969-3/abstract
  57. Waknine Y FDA Approvals: Fanapt and Cycloset Medscape Medical News http://www.medscape.com/viewarticle/702798 - Safety and Tolerability Study of Cycloset in Treatment of Type 2 Diabetes ClinicalTrials.gov http://clinicaltrials.gov/ct2/show/NCT00377676 - Prescriber's Letter 18(2): 2011 COMMENTARY: Cycloset: A New Bromocriptine Formulation for Diabetes CHART: Drug Classes for Type 2 Diabetes Detail-Document#: 270205 (subscription needed) http://www.prescribersletter.com
  58. Prescriber's Letter 17(5): 2010 CHART: Stepwise Approach to Selecting Treatments for Type 2 Diabetes (ADA) CHART: Stepwise Approach to Selecting Treatments for Type 2 Diabetes (AACE) CHART: Drug Classes for Type 2 Diabetes GUIDELINES: Consensus Statement on Management of Hyperglycemia in Type 2 Diabetes (ADA, 2009) GUIDELINES: Consensus Statement on Management of Hyperglycemia in Type 2 Diabetes (AACE/ACE, 2010) Detail-Document#: 260522 (subscription needed) http://www.prescribersletter.com
  59. Pignone M et al Aspirin for Primary Prevention of Cardiovascular Events in People With Diabetes: A Position Statement of the American Diabetes Association, a Scientific Statement of the American Heart Association, and an Expert Consensus Document of the American College of Cardiology Foundation Circulation. 2010 May 27 PMID: 20508178 http://circ.ahajournals.org/cgi/reprint/CIR.0b013e3181e3b133v1 - Pignone M et al Aspirin for Primary Prevention of Cardiovascular Events in People With Diabetes: A Position Statement of the American Diabetes Association, a Scientific Statement of the American Heart Association, and an Expert Consensus Document of the American College of Cardiology Foundation Diabetes Care. 2010 Jun;33(6):1395-402. No abstract available. PMID: 20508233
  60. Prescriber's Letter 17(7): 2010 COMMENTARY: Aspirin for Primary Prevention in Patients with Diabetes PATIENT HANDOUT: Aspirin and Your Heart PATIENT HANDOUT SPANISH VERSION: La Aspirina y el Corazon GUIDELINES: Aspirin for Primary Prevention of Cardiovascular Events in People with Diabetes Detail-Document#: 260708 (subscription needed) http://www.prescribersletter.com
  61. Cooper-DeHoff RM et al Tight Blood Pressure Control and Cardiovascular Outcomes Among Hypertensive Patients With Diabetes and Coronary Artery Disease. JAMA. 2010;304(1):61-68. PMID: 20606150 http://jama.ama-assn.org/cgi/content/short/304/1/61
  62. Church TS et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: A randomized controlled trial. JAMA 2010 Nov 24; 304:2253. PMID: 21098771
  63. Nylen ES, Kokkinos P, Myers J, Faselis C Prognostic effect of exercise capacity on mortality in older adults with diabetes mellitus. J Am Geriatr Soc. 2010 Oct;58(10):1850-4. PMID: 20929462
  64. Gonzalez-Perez A et al. Acute pancreatitis in association with type 2 diabetes and antidiabetic drugs: A population-based cohort study. Diabetes Care 2010 Dec; 33:2580. PMID: 20833867
  65. Prescriber's Letter 18(2): 2011 COMMENTARY: Cycloset: A New Bromocriptine Formulation for Diabetes CHART: Drug Classes for Type 2 Diabetes Detail-Document#: 270205 (subscription needed) http://www.prescribersletter.com
  66. Buse JB et al. Use of twice-daily exenatide in basal insulin-treated patients with type 2 diabetes: A randomized, controlled trial. Ann Intern Med 2011 Jan 18; 154:103 PMID: 21138825 - Nathan DM. Time for clinically relevant comparative effectiveness studies in type 2 diabetes. Ann Intern Med 2011 Jan 18; 154:131 PMID: 21135287
  67. Gross JL et al Effect of Antihyperglycemic Agents Added to Metformin and a Sulfonylurea on Glycemic Control and Weight Gain in Type 2 Diabetes: A Network Meta-analysis Annals of Internal Medicine May 16, 2011 154:672-679 PMID: 21576535 http://www.annals.org/content/154/10/672.full.pdf+html
  68. Schwartz AV et al. Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA 2011 Jun 1; 305:2184. PMID: 21632482
  69. Andrews RC et al. Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: The Early ACTID randomised controlled trial. Lancet 2011 Jun 25 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60442-X/fulltext - Hu FB. Diet and exercise for new-onset type 2 diabetes? Lancet 2011 Jun 25; http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60692-2/fulltext
  70. Prescriber's Letter 18(12): 2011 CHART: Initiation and Adjustment of Insulin Regimens for Type 2 Diabetes Detail-Document#: 271204 (subscription needed) http://www.prescribersletter.com
  71. Centers for Disease Control and Prevention Use of Hepatitis B Vaccination for Adults with Diabetes Mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR December 23, 2011 / 60(50);1709-1711 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a4.htm
  72. American College of Physicians - Qaseem A, Vijan S, Snow V, Cross JT, Weiss KB, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians. Ann Intern Med. 2007 Sep 18;147(6):417-22. Summary for patients in: Ann Intern Med. 2007 Sep 18;147(6): I52. PMID: 17876024 http://www.annals.org/cgi/content/abstract/147/6/417?etoc (Corresponding NGC guideline withdrawn Dec 2012)
  73. Qaseem A et al Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline From the American College of Physicians Annals of Internal Medicine Feb 7, 2012 156(3):218-231 PMID: 22312141 http://www.annals.org/content/156/3/218.full.pdf+html
  74. Ruiter R et al. Lower risk of cancer in patients on metformin in comparison with those on sulfonylurea derivatives: Results from a large population-based follow-up study. Diabetes Care 2012 Jan; 35:119 PMID: 22100960
  75. Farmer AJ et al. Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes. BMJ 2012 Feb 27; 344:e486 PMID: 22371867
  76. Schauer PR et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012 Mar 26 PMID: 22449319 http://www.nejm.org/doi/full/10.1056/NEJMoa1200225 - Mingrone G et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med 2012 Mar 26 PMID: 22449317 http://www.nejm.org/doi/full/10.1056/NEJMoa1200111
  77. Journal Watch: Physician's First Watch Massachusetts Medical Society - Leonetti F et al Obesity, Type 2 Diabetes Mellitus, and Other Comorbidities A Prospective Cohort Study of Laparoscopic Sleeve Gastrectomy vs Medical Treatment Arch Surg. Published online April 16, 2012 PMID: 22508671 http://archsurg.ama-assn.org/cgi/content/abstract/archsurg.2012.222
  78. Inzucchi SE et al Management of Hyperglycemia in Type2 Diabetes: A Patient-Centered Approach Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care April 19, 2012 PMID: 22517736 http://care.diabetesjournals.org/content/early/2012/04/17/dc12-0413.full.pdf+html - Cefalu WT. American Diabetes Association - European Association for the Study of Diabetes position statement: Due diligence was conducted. Diabetes Care 2012 Jun; 35:1201 PMID: 22619286
  79. Hemmingsen B et al. Comparison of metformin and insulin versus insulin alone for type 2 diabetes: Systematic review of randomised clinical trials with meta-analyses and trial sequential analyses. BMJ 2012 Apr 19; 344:e1771. PMID: 22517929
  80. Khunti K et al Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus: three year follow-up of a cluster randomised controlled trial in primary care BMJ 2012;344:e2333 PMID: 22539172 http://www.bmj.com/content/344/bmj.e2333 - Snoek FJ Self management education and good professional consultation skills for patients with diabetes BMJ 2012;344:e2673 PMID: 22539175 http://www.bmj.com/content/344/bmj.e2673
  81. Long JA et al. Peer mentoring and financial incentives to improve glucose control in African American veterans: A randomized trial. Ann Intern Med 2012 Mar 20; 156:416. PMID: 22431674
  82. Prescriber's Letter 19(6): 2012 CHART: Drugs for Type 2 Diabetes ALGORITHM: Stepwise Approach to Selecting Treatments for Type 2 Diabetes (ADA) GUIDELINES: Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach (2012) Detail-Document#: 280614 (subscription needed) http://www.prescribersletter.com
  83. The ORIGIN Trial Investigators. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 2012 Jun 11; PMID: 22686416 http://www.nejm.org/doi/full/10.1056/NEJMoa1203858
  84. The ORIGIN Trial Investigators. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med 2012 Jun 11 PMID: 22686415 http://general-medicine.jwatch.org/cgi/content/full/2012/612/2?q=etoc_jwgenmed
  85. ARUP Consult: Diabetes Mellitus deprecated reference
  86. Gallwitz B et al. Exenatide twice daily versus glimepiride for prevention of glycaemic deterioration in patients with type 2 diabetes with metformin failure (EUREXA): An open-label, randomised controlled trial. Lancet 2012 Jun 16; 379:2270 PMID: 22683137 - Aschner P et al. Insulin glargine versus sitagliptin in insulin-naive patients with type 2 diabetes mellitus uncontrolled on metformin (EASIE): A multicentre, randomised open-label trial. Lancet 2012 Jun 16; 379:2262 PMID: 22683131 - Gallwitz B et al. 2-year efficacy and safety of linagliptin compared with glimepiride in patients with type 2 diabetes inadequately controlled on metformin: A randomised, double-blind, non-inferiority trial. Lancet 2012 Jun 27 PMID: 22748821 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60691-6/fulltext
  87. Wang KL et al Statins, Risk of Diabetes, and Implications on Outcomes in the General Population ONLINE FIRST J Am Coll Cardiol. 2012;():. doi:10.1016, August 2012 PMID: 22884288 http://content.onlinejacc.org/article.aspx?articleID=1309632
  88. Yau CK et al. Glycosylated hemoglobin and functional decline in community- dwelling nursing home - eligible elderly adults with diabetes mellitus. J Am Geriatr Soc 2012 Jul; 60:1215. PMID: 22702660
  89. Copeland KL et al. Diabetes mellitus and sexual function in middle-aged and older women. Obstet Gynecol 2012 Aug; 120:331. PMID: 22825093
  90. NIH News, Oct 19, 2012 Weight loss does not lower heart disease risk from type 2 diabetes http://www.nih.gov/news/health/oct2012/niddk-19.htm
  91. Jenkins DJ et al Effect of Legumes as Part of a Low Glycemic Index Diet on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes Mellitus: A Randomized Controlled Trial Arch Intern Med. 2012 (Oct) PMID: 23089999 http://archinte.jamanetwork.com/article.aspx?articleid=1384247 - Franz MJ Diabetes Mellitus Nutrition Therapy. Beyond the Glycemic Index Comment on "Effect of Legumes as Part of a Low Glycemic Index Diet on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes Mellitus" Arch Intern Med. 2012 (Oct) PMID: 23090061 http://archinte.jamanetwork.com/article.aspx?articleid=1384248
  92. Prescriber's Letter 19(11): 2012 Which Diabetes Patients Need an ACE Inhibitor or ARB, Aspirin, and Statin? Detail-Document#: 281124 (subscription needed) http://www.prescribersletter.com
  93. Prescriber's Letter 19(11): 2012 Managing Type 2 Diabetes in Elderly Patients Detail-Document#: 281128 (subscription needed) http://www.prescribersletter.com
  94. Roumie CL et al. Comparative effectiveness of sulfonylurea and metformin monotherapy on cardiovascular events in type 2 diabetes mellitus: A cohort study. Ann Intern Med 2012 Nov 6; 157:601 PMID: 23128859
  95. Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF et al 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14;374(9702):1677-86. PMID: 19878986
  96. Prescriber's Letter 20(3): 2013 COMMENTARY: Sick Day Management of Diabetes PATIENT EDUCATION HANDOUT: How to Manage Sick Days with Diabetes Detail-Document#: 290320 (subscription needed) http://www.prescribersletter.com
  97. Basu S et al. The relationship of sugar to population-level diabetes prevalence: An econometric analysis of repeated cross- sectional data. PLoS ONE 2013 Feb 27; 8:e57873. PMID: 23460912
  98. Reimondo G, Pia A, Allasino B et al Screening of Cushing's syndrome in adult patients with newly diagnosed diabetes mellitus. Clin Endocrinol (Oxf). 2007 Aug;67(2):225-9. Epub 2007 Jun 4. PMID: 17547690
  99. Buse JB et al Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes (DURATION-6): A randomised, open-label study. Lancet 2012 Nov 7 PMID: 23141817 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61267-7/fulltext
  100. Maggard-Gibbons M et al Bariatric Surgery for Weight Loss and Glycemic Control in Nonmorbidly Obese Adults With Diabetes. A Systematic Review. JAMA. 2013;309(21):2250-2261 PMID: 23736734 http://jama.jamanetwork.com/article.aspx?articleid=1693893 - Ikramuddin S et al Roux-en-Y Gastric Bypass vs Intensive Medical Management for the Control of Type 2 Diabetes, Hypertension, and Hyperlipidemia. The Diabetes Surgery Study Randomized Clinical Trial. JAMA. 2013;309(21):2240-2249 PMID: 23736733 http://jama.jamanetwork.com/article.aspx?articleid=1693889 - Wolfe BM et al Treating Diabetes With Surgery. JAMA. 2013;309(21):2274-2275 PMID: 23736737 http://jama.jamanetwork.com/article.aspx?articleid=1693867
  101. American Diabetes Association. Standards of medical care in diabetes--2012. Diabetes Care. 2012 Jan;35 Suppl 1:S11-63. PMID: 22187469
  102. Hong J et al. Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease. Diabetes Care 2013 May; 36:1304. PMID: 23230096
  103. Yaffe K et al. Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus. JAMA Intern Med 2013 Jun 10 PMID: 23753199 http://archinte.jamanetwork.com/article.aspx?articleid=1696172
  104. The Look AHEAD Research Group Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes. N Engl J Med. June 24, 2013 PMID: 23796131 http://www.nejm.org/doi/full/10.1056/NEJMoa1212914 - Gerstein HC Do Lifestyle Changes Reduce Serious Outcomes in Diabetes? N Engl J Med. June 24, 2013 PMID: 23796132 http://www.nejm.org/doi/full/10.1056/NEJMe1306987
  105. Goldfine AB et al Salicylate (Salsalate) in Patients With Type 2 Diabetes: A Randomized Trial. Ann Intern Med. 2013;159(1):1-12 PMID: 23817699 https://annals.org/article.aspx?articleID=1700640
  106. Antoniou T et al Comparative effectiveness of angiotensin-receptor blockers for preventing macrovascular disease in patients with diabetes: a population-based cohort study. CMAJ. July 8, 2013 PMID: 23836857 http://www.cmaj.ca/content/early/2013/07/08/cmaj.121771.full.pdf+html - Cooper ME Choosing the right angiotensin-receptor blocker for patients with diabetes: still controversial. CMAJ. July 8, 2013 PMID: 23836856 http://www.cmaj.ca/content/early/2013/07/08/cmaj.130507
  107. Karlsson FH et al. Gut metagenome in European women with normal, impaired and diabetic glucose control. Nature 2013 Jun 6; 498:99. PMID: 23719380 - e Vos WM and Nieuwdorp M. A gut prediction. Nature 2013 Jun 6; 498:48. PMID: 23719383
  108. Marwick TH, Hordern MD, Miller T et al Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009 Jun 30;119(25):3244-62 PMID: 19506108
  109. Corella D et al Mediterranean Diet Reduces the Adverse Effect of the TCF7L2- rs7903146 Polymorphism on Cardiovascular Risk Factors and Stroke Incidence. A randomized controlled trial in a high- cardiovascular-risk population. PMID: 23942586 http://care.diabetesjournals.org/content/early/2013/08/06/dc13-0955.abstract
  110. Schellenberg ES, Dryden DM, Vandermeer B et al Lifestyle Interventions for Patients With and at Risk for Type 2 Diabetes: A Systematic Review and Meta-analysis. Ann Intern Med. 2013;159(8): 543-551 PMID: 24126648 http://annals.org/article.aspx?articleid=1748845
  111. Prescriber's Letter 20(11): 2013 CHART: Drugs for Type 2 Diabetes ALGORITHM: Stepwise Approach to Selecting Treatments for Type 2 Diabetes (ADA) Detail-Document#: 291121 (subscription needed) http://www.prescribersletter.com
  112. Shen L et al Role of diuretics, beta-blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study. BMJ 2013;347:f6745 PMID: 24322398 http://www.bmj.com/content/347/bmj.f6745
  113. Okada-Iwabu M et al. A small-molecule AdipoR agonist for type 2 diabetes and short life in obesity. Nature 2013 Nov 28; 503:493 PMID: 24172895
  114. Tobias DK et al Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes. N Engl J Med 2014; 370:233-244. January 16, 2014 PMID: 24428469 http://www.nejm.org/doi/full/10.1056/NEJMoa1304501
  115. Flannick J et al Loss-of-function mutations in SLC30A8 protect against type 2 diabetes. Nature Genetics. Mach 2, 2014 PMID: 24584071 http://www.nature.com/ng/journal/vaop/ncurrent/full/ng.2915.html
  116. Teeuw WJ, Gerdes VE, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care. 2010 Feb;33(2):421-7. PMID: 20103557
  117. Geller AI et al. National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations. JAMA Intern Med 2014 Mar 10; PMID: 24615164 http://archinte.jamanetwork.com/article.aspx?articleid=1835360 - Lee SJ. So much insulin, so much hypoglycemia. JAMA Intern Med 2014 Mar 10 PMID: 24614940 http://archinte.jamanetwork.com/article.aspx?articleid=1835356
  118. Prescriber's Letter 21(4): 2014 Improving Diabetes Outcomes and Meeting Quality Measures. Detail-Document#: 300422 (subscription needed) http://www.prescribersletter.com
  119. Patel A1; ADVANCE Collaborative Group, MacMahon S et al Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007 Sep 8;370(9590):829-40. PMID: 17765963
  120. Neumiller JJ, Setter SM. Pharmacologic management of the older patient with type 2 diabetes mellitus. Am J Geriatr Pharmacother. 2009 Dec;7(6):324-42. PMID: 20129254
  121. Wolfram T, Ismail-Beigi F. Efficacy of high-fiber diets in the management of type 2 diabetes mellitus. Endocr Pract. 2011 Jan-Feb;17(1):132-42. Review. PMID: 20713332
  122. Malanda UL, Welschen LM, Riphagen II et al Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database Syst Rev. 2012 Jan 18;1:CD005060 PMID: 22258959
  123. Uribarri J, Cai W, Ramdas M et al Restriction of advanced glycation end products improves insulin resistance in human type 2 diabetes: potential role of AGER1 and SIRT1. Diabetes Care. 2011 Jul;34(7):1610-6. doi: 10.2337/dc11-0091. PMID: 21709297
  124. Halperin F, Ding SA2, Simonson DC et al Roux-en-Y Gastric Bypass Surgery or Lifestyle With Intensive Medical Management in Patients With Type 2 Diabetes. Feasibility and 1-Year Results of a Randomized Clinical Trial. JAMA Surg. Published online June 04, 2014. PMID: 24899464 http://archsurg.jamanetwork.com/article.aspx?articleid=1876617 - Courcoulas AP et al Surgical vs Medical Treatments for Type 2 Diabetes Mellitus. A Randomized Clinical Trial. JAMA Surg. Published online June 04, 2014. PMID: 24899268 http://archsurg.jamanetwork.com/article.aspx?articleid=1876616
  125. Roumie CL et al. Association between intensification of metformin treatment with insulin vs sulfonylureas and cardiovascular events and all-cause mortality among patients with diabetes. JAMA 2014 Jun 11; 311:2288 PMID: 24915260 http://www.jwatch.org/na34894/2014/06/10/insulin-or-sulfonylureas-supplement-metformin-patients
  126. Sjostrom L et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014 Jun 11; 311:2297. PMID: 24915261
  127. Soloway B Insulin Pump Lowers HbA1c Better Than Basal-Bolus Injections in Type 2 Diabetes. NEJM Journal Watch. July 15, 2014 Massachusetts Medical Society (subscription needed) http://www.jwatch.org - Reznik Y et al. Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): A randomised open- label controlled trial. Lancet 2014 Jul 3; PMID: 24998009 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961037-0/fulltext
  128. Eng C, Kramer CK, Zinman B, Retnakaran R Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. The Lancet, Early Online Publication, 12 September 2014 PMID: 25220191 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961335-0/abstract
  129. Menke A et al. Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: A series of cross-sectional studies. Ann Intern Med 2014 Sep 2; 161:328. PMID: 25178569
  130. Berkowitz SA et al Initial Choice of Oral Glucose-Lowering Medication for Diabetes Mellitus. A Patient-Centered Comparative Effectiveness Study JAMA Intern Med. Published online October 27, 2014 PMID: 25347323 http://archinte.jamanetwork.com/article.aspx?articleid=1918925 - Segal JB, Maruthur NM Initial Therapy for Diabetes Mellitus. JAMA Intern Med. Published online October 27, 2014 PMID: 25347083 http://archinte.jamanetwork.com/article.aspx?articleid=1918922
  131. Ali MK et al A Cascade of Care for Diabetes in the United States: Visualizing the Gaps. Ann Intern Med. 2014;161(10):681-689. PMID: 25402511 http://annals.org/article.aspx?articleid=1935052
  132. Stone NJ et al 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk on Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. Nov 12, 2013 PMID: 24222016 http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a
  133. Muhlestein JB et al. Effect of screening for coronary artery disease using CT angiography on mortality and cardiac events in high-risk patients with diabetes: The FACTOR-64 randomized clinical trial. JAMA 2014 Nov 17; PMID: 25402757 http://jama.jamanetwork.com/article.aspx?articleid=1936754 - Gibbons RJ. Optimal medical therapy vs CT angiography screening for patients with diabetes. JAMA 2014 Nov 17 PMID: 25402605 http://jama.jamanetwork.com/article.aspx?articleid=1936751
  134. Sacks FM et al Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity. The OmniCarb Randomized Clinical Trial. JAMA. 2014;312(23):2531-2541 PMID: 25514303 http://jama.jamanetwork.com/article.aspx?articleid=2040224#joi140167r3
  135. American Diabetes Association Standards of Medical Care in Diabetes-2015: Summary of Revisions Diabetes Care. Jan 2015. 38:S1-S2 http://care.diabetesjournals.org/content/38/Supplement_1
  136. Rawlings AM et al. Diabetes in midlife and cognitive change over 20 years: A cohort study. Ann Intern Med 2014 Dec 2; 161:785 PMID: 25437406 http://annals.org/article.aspx?articleid=1983393
  137. Lipska KJ et al Potential Overtreatment of Diabetes Mellitus in Older Adults With Tight Glycemic Control. JAMA Intern Med. Published online January 12, 2015 PMID: 25581565 http://archinte.jamanetwork.com/article.aspx?articleid=2089233
  138. Orciari Herman A, Sadoughi S, Saitz R More TV Watching Associated with Higher Diabetes Risk Physician's First Watch, April 2, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org - Rockette-Wagner B et al The impact of lifestyle intervention on sedentary time in individuals at high risk of diabetes. Diabetologia. March 2015 PMID: 25851102
  139. Lycett D et al The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study. The Lancet Diabetes & Endocrinology. April 29, 2015 PMID: 25935880 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2815%2900082-0/abstract
  140. Powers MA et al Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care. June 5, 2015 PMID: 26048904 http://care.diabetesjournals.org/content/early/2015/06/02/dc15-0730.full.pdf+html
  141. Fox CS et al Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care. August 5, 2015 PMID: 26246459 http://care.diabetesjournals.org/content/early/2015/08/05/dci15-0012.1.full.pdf
  142. Gaede P, Lund-Andersen H, Parving HH, Pedersen O Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008 Feb 7;358(6):580-91. PMID: 18256393
  143. Menke A et al Prevalence of and Trends in Diabetes Among Adults in the United States, 1988=2012. JAMA. 2015;314(10):1021-1029 PMID: 26348752 http://jama.jamanetwork.com/article.aspx?articleid=2434682 - Herman WH, RothbergMossello Prevalence of Diabetes in the United States. A Glimmer of Hope? JAMA. 2015;314(10):1005-1007. PMID: 26348749 http://jama.jamanetwork.com/article.aspx?articleid=2434665
  144. Ou SM, Shih CJ, Chao PW et al Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus. Ann Intern Med. 2015 Oct 13. PMID: 26457538
  145. Sussman JB, Kerr EA, Saini SD et al Rates of Deintensification of Blood Pressure and Glycemic Medication Treatment Based on Levels of Control and Life Expectancy in Older Patients With Diabetes Mellitus. JAMA Intern Med. Published online October 26, 2015 PMID: 26502220 http://archinte.jamanetwork.com/article.aspx?articleid=2466632 - Caverly TJ, Fagerlin A, Zikmund-Fisher BJ et al Appropriate Prescribing for Patients With Diabetes at High Risk for Hypoglycemia. National Survey of Veterans Affairs Health Care Professionals. JAMA Intern Med. Published online October 26, 2015 PMID: 26502113 http://archinte.jamanetwork.com/article.aspx?articleid=2466631 - Mossello E Targeting Vascular Risk Factors in Older Adults. From Polypill to Personalized Prevention. JAMA Intern Med. Published online October 26, 2015 PMID: 26502030 http://archinte.jamanetwork.com/article.aspx?articleid=2466630
  146. Lind M et al Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial). BMJ 2015;351:h5364 PMID: 26512041 http://www.bmj.com/content/351/bmj.h5364
  147. Garber AJ et al AACE/ACE Consensus Statement CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM - 2016 EXECUTIVE SUMMARY. ENDOCRINE PRACTICE Vol 22 No. 1 January 2016 PMID: 26731084 https://www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf - Garber AJ et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2017 executive summary. Endocr Pract 2017 Feb; 23:207. PMID: 28095040
  148. Gregg EW, Chen H, Wagenknecht LE et al Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA. 2012 Dec 19;308(23):2489-96. PMID: 23288372
  149. Maldonado MR, Otiniano ME, Cheema F et al Factors associated with insulin discontinuation in subjects with ketosis-prone diabetes but preserved beta-cell function. Diabet Med. 2005 Dec;22(12):1744-50. PMID: 16401322
  150. Lingvay I et al Effect of Insulin Glargine Up-titration vs Insulin Degludec/ Liraglutide on Glycated Hemoglobin Levels in Patients With Uncontrolled Type 2 Diabetes. The DUAL V Randomized Clinical Trial. JAMA. 2016;315(9):898-907 PMID: 26934259 http://jama.jamanetwork.com/article.aspx?articleid=2497908
  151. Bangalore S, Fakheri R, Toklu B, Messerli FH Diabetes mellitus as a compelling indication for use of renin angiotensin system blockers: Systematic review and meta-analysis of randomized trials. BMJ 2016 Feb 11; 352:i438. PMID: 26868137 Free Article - Majumdar SR. Antihypertensive treatments for adults with type 2 diabetes. BMJ 2016 Feb 11; 352:i560. PMID: 26867645
  152. Maruthur NM et al Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis. Ann Intern Med. Published online 19 April 2016 PMID: 27088241 http://annals.org/article.aspx?articleid=2513979
  153. Rubino F et al Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care 2016 Jun; 39(6): 861-877 PMID: 27222544 http://care.diabetesjournals.org/content/39/6/861 - Cefalu WT et al Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care. Diabetes Care 2016 Jun; 39(6): 857-860 PMID: 27222543 http://care.diabetesjournals.org/content/39/6/857
  154. Henson J et al. Breaking up prolonged sitting with standing or walking attenuates the postprandial metabolic response in postmenopausal women: A randomized acute study. Diabetes Care 2016 Jan; 39:130 PMID: 26628415 Free PMC Article http://care.diabetesjournals.org/content/39/1/130 - Dempsey PC et al. Benefits for type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities. Diabetes Care 2016 Jun; 39:964 PMID: 27208318
  155. Amblee A, Lious D, Fogelfeld L. Combination of saxagliptin and metformin is effective as initial therapy in new-onset type 2 diabetes mellitus with severe hyperglycemia. J Clin Endocrinol Metab 2016 Jun; 101:2528 PMID: 27144930
  156. Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  157. Lee SJ, Boscardin WJ, Stijacic Cenzer I et al The risks and benefits of implementing glycemic control guidelines in frail older adults with diabetes mellitus. J Am Geriatr Soc. 2011 Apr;59(4):666-72. Epub 2011 Apr 11. PMID: 21480838 Free PMC Article - Lee SJ, Eng C. Goals of glycemic control in frail older patients with diabetes. JAMA. 2011 Apr 6;305(13):1350-1.No abstract available. PMID: 21467289 Free PMC Article
  158. Kirkman MS, Briscoe VJ, Clark N et al Diabetes in older adults: a consensus report. J Am Geriatr Soc. 2012 Dec;60(12):2342-56. Epub 2012 Oct 25. PMID: 23106132 Free PMC Article
  159. Bajwa SJ, Sehgal V, Kalra S, Baruah MP. Management of diabetes mellitus type-2 in the geriatric population: Current perspectives. J Pharm Bioallied Sci. 2014 Jul;6(3):151-7. Review. PMID: 25035634 Free PMC Article
  160. Palmer SC, Mavridis D, Nicolucci A et al Comparison of Clinical Outcomes and Adverse Events Associated With Glucose-Lowering Drugs in Patients With Type 2 Diabetes. A Meta-analysis. JAMA. 2016;316(3):313-324 PMID: 27434443 http://jama.jamanetwork.com/article.aspx?articleid=2533506
  161. Scarlett JM et al. Central injection of fibroblast growth factor 1 induces sustained remission of diabetic hyperglycemia in rodents. Nat Med 2016 Jul; 22:800. PMID: 27213816
  162. Eryd SA et al Blood pressure and complications in individuals with type 2 diabetes and no previous cardiovascular disease: national population based cohort study. BMJ 2016;354:i4070 PMID: 27492939 http://www.bmj.com/content/354/bmj.i4070
  163. Hippisley-Cox J, Coupland C. Diabetes treatments and risk of heart failure, cardiovascular disease, and all cause mortality: Cohort study in primary care. BMJ 2016 Jul 16; 354:i3477. PMID: 27413012 Free PMC Article
  164. Colberg SR, Sigal RJ, Yardley JE et al Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016 Nov; 39(11): 2065-2079 PMID: 27926890 http://care.diabetesjournals.org/content/39/11/2065
  165. Tsujimoto T, Sugiyama T, Noda M, Kajio H. Intensive Glycemic Therapy in Patients With Type 2 Diabetes on beta-Blockers. Diabetes Care 2016 Oct; 39(10): 1818-1826 PMID: 27460066 http://care.diabetesjournals.org/content/39/10/1818
  166. Driver BE et al. Discharge glucose is not associated with short-term adverse outcomes in emergency department patients with moderate to severe hyperglycemia. Ann Emerg Med 2016 Dec; 68:697 PMID: 27353284 http://www.annemergmed.com/article/S0196-0644(16)30162-7/abstract
  167. Qaseem A, Barry MJ, Humphrey LL et al. Oral pharmacologic treatment of type 2 diabetes mellitus: A clinical practice guideline update from the American College of Physicians. Ann Intern Med 2017 Jan 3; [e-pub]. PMID: 28055075 - Fradkin JE, Rodgers GP. Glycemic therapy for type 2 diabetes: Choices expand, data lag behind. Ann Intern Med 2017 Jan 3; PMID: 28055042
  168. Schauer PR, Bhatt DL, Kirwan JP et al Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med 2017; 376:641-651. February 16, 2017 PMID: 28199805 http://www.nejm.org/doi/full/10.1056/NEJMoa1600869
  169. Chamberlain JJ, Herman WH, Leal S et al Pharmacologic Therapy for Type 2 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. March 14, 2017. PMID: 28288484 http://annals.org/aim/article/2609290/pharmacologic-therapy-type-2-diabetes-synopsis-2017-american-diabetes-association
  170. Mayer-Davis EJ, Lawrence JM, Dabelea D et al Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012. N Engl J Med 2017; 376:1419-1429. April 13, 2017 PMID: 28402773 http://www.nejm.org/doi/full/10.1056/NEJMoa1610187
  171. Rawshani A, Rawshani A, Franzen S et al Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes. N Engl J Med 2017; 376:1407-1418. April 13, 2017 PMID: 28402770 http://www.nejm.org/doi/full/10.1056/NEJMoa1608664
  172. Furler J et al. Supporting insulin initiation in type 2 diabetes in primary care: Results of the Stepping Up pragmatic cluster randomised controlled clinical trial. BMJ 2017 Mar 8; 356:j783. PMID: 28274941 Free full text
  173. Huang ES. Management of diabetes mellitus in older people with comorbidities. BMJ. 2016;353:i2200 PMID: 27307175 Free full text
  174. Lipska KJ, Krumholz H, Soones T, et al. Polypharmacy in the aging patient: a review of glycemic control in older adults with type 2 diabetes. JAMA. 2016;315:1034-1045 PMID: 26954412 Free PMC Article
  175. Young LA, Buse JB, Weaver MA et al Glucose Self-monitoring in Non-Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings. A Randomized Trial. JAMA Intern Med. Published online June 10, 2017 PMID: 28600913 http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2630691 - Khoong EC, Ross JS The Need to Test Strategies Based on Common Sense. JAMA Intern Med. Published online June 10, 2017 PMID: 28600912 http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2630690
  176. Wysham C, Bhargava A, Chaykin L et al Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes. The SWITCH 2 Randomized Clinical Trial. JAMA. 2017;318(1):45-56. PMID: 28672317 http://jamanetwork.com/journals/jama/article-abstract/2635630
  177. Beck RW, Riddlesworth TD, Ruedy K et al Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections: A Randomized Trial. Ann Intern Med. Aug 22, 2017. PMID: 2882848 http://annals.org/aim/article/2649297/continuous-glucose-monitoring-versus-usual-care-patients-type-2-diabetes - Arguello V, Freeby M Continuous Glucose Monitoring in Patients With Type 2 Diabetes Receiving Insulin Injections: Does This Mean Continuous Glucose Monitoring for Everyone? Ann Intern Med. Aug 22, 2017. PMID: 28828490 http://annals.org/aim/article/2650838/continuous-glucose-monitoring-patients-type-2-diabetes-receiving-insulin-injections
  178. Vaccaro O, Masulli M, Nicolucci A et al Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial. The Lancet Diabetes & Endocrinology. Sept 13, 2017 PMID: 28917544 http://thelancet.com/journals/landia/article/PIIS2213-8587(17)30317-0/fulltext - Fonseca VA, Lovre D Pioglitazone versus sulfonylureas: cardiovascular outcomes with older diabetes drugs. The Lancet Diabetes & Endocrinology. Sept 13, 2017 PMID: 28917543 http://thelancet.com/journals/laneur/article/PIIS2213-8587(17)30320-0/fulltext
  179. Holman RR, Bethel MA, Mentz RJ et la Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2017 Sep 14. PMID: 28910237 http://www.nejm.org/doi/full/10.1056/NEJMoa1612917
  180. Conlin PR, Colburn J, Aron D, Pries RM, Tschanz MP, Pogach L. Synopsis of the 2017 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline: Management of type 2 diabetes mellitus. Ann Intern Med 2017 Oct 24 PMID: 29059687
  181. Lean ME, Leslie WS, Barnes AC et al Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. Dec 5, 2017 PMID: 29221645 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext - Uusitupa M Remission of type 2 diabetes: mission not impossible. Lancet. Dec 5, 2017 PMID: 29221646 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33100-8/fulltext
  182. Tucker ME ADA 2018 Standards Address Diabetes Drugs With CV Benefit. Medscape. Dec 08, 2017. https://www.medscape.com/viewarticle/889800 - Shubrook JH, Johnson EL ADA 2018 Abridged Standards of Medical Care in Diabetes: Update for Primary Care. Medscape. Dec 08, 2017. https://www.medscape.com/viewarticle/889401 - American Diabetes Association Introduction: Standards of Medical Care in Diabetes - 2018. Diabetes Care 2018 Jan; 41(Supplement 1): S1-S2 PMID: 29222369 http://care.diabetesjournals.org/content/41/Supplement_1/S1 - American Diabetes Association Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018 Jan;41(Suppl 1):S7-S12. Review. PMID: 29222372 - American Diabetes Association Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S13-S27. Review. PMID: 29222373 - American Diabetes Association Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S28-S37. Review. PMID: 29222374 - American Diabetes Association Lifestyle Management: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S38-S50. Review. PMID: 29222375 - American Diabetes Association Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S51-S54. Review. PMID: 29222376 - American Diabetes Association Glycemic Targets: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S55-S64. Review. PMID: 29222377 - American Diabetes Association Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S65-S72. Review. PMID: 29222378 - American Diabetes Association Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S73-S85. Review. PMID: 29222379 - American Diabetes Association Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S86-S104. Review. PMID: 29222380 - American Diabetes Association Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S105-S118. Review. PMID: 29222381 - American Diabetes Association Older Adults: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S119-S125. Review. PMID: 29222382 - American Diabetes Association Older Adults: Standards of Medical Care in Diabetes-2021 Diabetes Care 2021;44(Supplement_1):S168-S179 PubMed: 33298423 - American Diabetes Association Children and Adolescents: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S126-S136. Review. PMID: 29222383 - American Diabetes Association Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S137-S143. Review. PMID: 29222384 - American Diabetes Association Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S144-S151. Review. PMID: 29222385 - American Diabetes Association. Diabetes Advocacy: Standards of Medical Care in Diabetes-2018 Diabetes Care. 2018 Jan;41(Suppl 1):S152-S153. Review. PMID: 29222386
  183. Hooper P, Boucher MC, Cruess A, et al. Excerpt from the Canadian Ophthalmological Society evidence- based clinical practice guidelines for the management of diabetic retinopathy. Can J Ophthalmol. 2017 Nov;52 Suppl 1:S45-S74 PMID: 29074014 http://www.canadianjournalofophthalmology.ca/article/S0008-4182(17)31047-5/fulltext
  184. Laiteerapong N, Cooper JM, Skandari MR et al Individualized Glycemic Control for U.S. Adults With Type 2 Diabetes: A Cost-Effectiveness Analysis. Ann Intern Med. 2017. Dec 12. PMID: 29230472 http://annals.org/aim/article-abstract/2665902/individualized-glycemic-control-u-s-adults-type-2-diabetes-cost
  185. Busko M FDA Approves SGLT2 Inhibitor Ertugliflozin for Type 2 Diabetes Medscape. Dec 21, 2017. https://www.medscape.com/viewarticle/890446
  186. Patorno E, Goldfine AB, Schneeweiss S. Cardiovascular outcomes associated with canagliflozin versus other non-gliflozin antidiabetic drugs: population based cohort study. BMJ 2018;360:k119 PMID: 29437648 Free Article http://www.bmj.com/content/360/bmj.k119
  187. Thereaux J, Lesuffleur1 T, Czernichow S et al Association Between Bariatric Surgery and Rates of Continuation, Discontinuation, or Initiation of Antidiabetes Treatment 6 Years Later. JAMA Surg. Published online Feb 14, 2018 PMID: 29450469 https://jamanetwork.com/journals/jamasurgery/fullarticle/2672216 - Gagner M Toward a National Surgical Strategy for Type 2 Diabetes Resolution. Can We Do Better? JAMA Surg. Published online Feb 14, 2018 PMID: 29450454 https://jamanetwork.com/journals/jamasurgery/article-abstract/2672212
  188. Waldman B, Ansquer JC, Sullivan DR et al Effect of fenofibrate on uric acid and gout in type 2 diabetes: a post-hoc analysis of the randomised, controlled FIELD study. Lancet Diabetes & Endocrinology. Feb 26, 2018 PMID: 29496472 http://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(18)30029-9.pdf
  189. Qaseem A, Wilt TJ, Kansagara D et al Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update From the American College of Physicians. Ann Intern Med. 2018. March 6. PMID: 29507945 http://annals.org/aim/fullarticle/2674121/hemoglobin-1c-targets-glycemic-control-pharmacologic-therapy-nonpregnant-adults-type
  190. Marcum ZA, Forsberg CW, Moore KP et al. Mortality associated with metformin versus sulfonylurea initiation: A cohort study of veterans with diabetes and chronic kidney disease. J Gen Intern Med 2018 Feb; 33:155. PMID: 29181788 https://link.springer.com/article/10.1007%2Fs11606-017-4219-3
  191. Bjerregaard LG, Jensen BW, Angquist L et al Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes. N Engl J Med 2018; 378:1302-1312. April 5, 2018 PMID: 29617589 http://www.nejm.org/doi/full/10.1056/NEJMoa1713231
  192. Tucker ME Beta-Blockers May Raise Mortality in People With Diabetes Medscape. Apr 05, 2018. https://www.medscape.com/viewarticle/894878
  193. Zheng SL, Roddick AJ, Aghar-Jaffar R, et al Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes. A Systematic Review and Meta-analysis. JAMA. 2018;319(15):1580-1591. PMID: 29677303 https://jamanetwork.com/journals/jama/fullarticle/2678616
  194. Chamberlain JJ, Johnson EL, Leal S et al. Cardiovascular Disease and Risk Management: Review of the American Diabetes Association Standards of Medical Care in Diabetes 2018. Ann Intern Med 2018 Apr 3; PMID: 29610837 http://annals.org/aim/fullarticle/2677350/cardiovascular-disease-risk-management-review-american-diabetes-association-standards-medical
  195. Douros A et al Sulfonylureas as second line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycaemic events: population based cohort study. BMJ 2018;362:k2693 PMID: 30021781 https://www.bmj.com/content/362/bmj.k2693 - McGowan LD, Roumie CL. Sulfonylureas as second line treatment for type 2 diabetes. BMJ 2018;362:k3041 PMID: 30021790 https://www.bmj.com/content/362/bmj.k3041
  196. Rawshani A, Rawshani A, Franzen S et al Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2018; 379:633-644. Aug 16, 2018 PMID: 30110583 https://www.nejm.org/doi/full/10.1056/NEJMoa1800256
  197. The ASCEND Study Collaborative Group. Effects of aspirin for primary prevention in persons with diabetes mellitus. N Engl J Med 2018 Aug 26; PMID: 30146931 Free Article https://www.nejm.org/doi/10.1056/NEJMoa1804988
  198. The ASCEND Study Collaborative Group. Effects of n-3 fatty acid supplements in diabetes mellitus N Engl J Med 2018 Aug 26; PMID: 30146932 Free Article https://www.nejm.org/doi/10.1056/NEJMoa1804989
  199. Roglic G, Norris SL Medicines for Treatment Intensification in Type 2 Diabetes and Type of Insulin in Type 1 and Type 2 Diabetes in Low-Resource Settings: Synopsis of the World Health Organization Guidelines on Second- and Third-Line Medicines and Type of Insulin for the Control of Blood Glucose Levels in Nonpregnant Adults With Diabetes Mellitus. Ann Intern Med. 2018. Sept 4. PMID: 30178023 http://annals.org/aim/fullarticle/2698900/medicines-treatment-intensification-type-2-diabetes-type-insulin-type-1 - Humphrey LL, Kansagara D, Qaseem A. World Health Organization Guidelines on Medicines for Diabetes Treatment Intensification: Commentary From the American College of Physicians High Value Care Committee. Ann Intern Med. 2018. Sept 4. PMID: 30178054 http://annals.org/aim/article-abstract/2698899/world-health-organization-guidelines-medicines-diabetes-treatment-intensification-commentary-from
  200. Am I at Risk for Type 2 Diabetes? http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm
  201. Hsu PF, Sung SS, Cheng HM et al. Cardiovascular benefits of acarbose vs sulfonylureas in patients with type 2 diabetes treated with metformin. J Clin Endocrinol Metab 2018 Oct 1; 103:3611 PMID: 30113697 https://academic.oup.com/jcem/article-abstract/103/10/3611/5063484
  202. Bohula EA et al. Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): A randomised, placebo-controlled trial. Lancet 2018 Oct 4; PMID: 30293771 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32328-6/fulltext - Unamuno X, Fruhbeck G. Lorcaserin: Balancing efficacy with potential risks. Lancet 2018 Oct 4 PMID: 30293772 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32460-7/fulltext
  203. Jackson GL, Smith VA, Edelman D et al Intermediate Diabetes Outcomes in Patients Managed by Physicians, Nurse Practitioners, or Physician Assistants: A Cohort Study Ann Intern Med. 2018. Nov 20, PMID: 30458506 http://annals.org/aim/article-abstract/2716077/intermediate-diabetes-outcomes-patients-managed-physicians-nurse-practitioners-physician-assistants - Peters AL The Changing Definition of a Primary Care Provider. Ann Intern Med. 2018. Nov 20, PMID: 30458467 http://annals.org/aim/article-abstract/2715822/changing-definition-primary-care-provider
  204. Writing Committee, Das SR, Everett BM, Birtcher KK et al 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease. A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol. Nov 2018 PMID: 30497881 http://www.onlinejacc.org/content/early/2018/11/23/j.jacc.2018.09.020
  205. Platt KD, Thompson AN, Lin P et al Assessment of Self-monitoring of Blood Glucose in Individuals With Type 2 Diabetes Not Using Insulin. JAMA Intern Med. Published online December 10, 2018. PMID: 30534950 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2717953
  206. American Diabetes Association Summary of Revisions: Standards of Medical Care in Diabetes - 2019. Diabetes Care 2019 Jan; 42(Supplement 1): S4-S6. PMID: 30559226 http://care.diabetesjournals.org/content/42/Supplement_1/S4 - American Diabetes Association Table of Contents Diabetes Care 2019 Jan; 42(Supplement 1): http://care.diabetesjournals.org/content/42/Supplement_1
  207. Ke C, Lau E, Shah BR et al Excess Burden of Mental Illness and Hospitalization in Young-Onset Type 2 Diabetes: A Population-Based Cohort Study. Ann Intern Med. 2019. Jan 15. PMID: 30641547 http://annals.org/aim/article-abstract/2720956/excess-burden-mental-illness-hospitalization-young-onset-type-2-diabetes
  208. Barry MJ, Humphrey LL, Qaseem A. Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus. Ann Intern Med. 2017 Jul 4;167(1):75-76. PMID: 28672387
  209. Zinman B, Bhosekar V, Busch R et al Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial. Lancet Diabetes & Endocrinology. March 01, 2019 PMID: 30833170 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30066-X/fulltext - Del Prato S. Rational combination therapy for type 2 diabetes. Lancet Diabetes & Endocrinology. March 01, 2019 PMID: 30833171 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30069-5/fulltext
  210. Bergenstal RM, Johnson M, Passi R et al. Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: A multicentre, randomised controlled trial. Lancet 2019 Feb 22; 393:1138. PMID: 30808512 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30368-X/fulltext - Evans ML, Golubic R. Technology to overcome clinical inertia in insulin therapy. Lancet 2019 Feb 22; 393:1078. PMID: 30808513 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30416-7/fulltext
  211. LeRoith D, Biessels GJ, Braithwaite SS et al Treatment of Diabetes in Older Adults: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, jc.2019-00198. March 23, 2019 https://academic.oup.com/jcem/advance-article/doi/10.1210/jc.2019-00198/5413486
  212. American Diabetes Association Issues Critical Updates to the 2019 Standards of Medical Care in Diabetes. News Release. March 27, 2019 http://www.diabetes.org/newsroom/press-releases/2019/ada-issues-critical-updates-to-2019-standards-of-care.html
  213. Sattar N, Rawshani A, Franzen S et al Age at Diagnosis of Type 2 Diabetes Mellitus and Associations With Cardiovascular and Mortality Risks Findings From the Swedish National Diabetes Registry. Circulation. April 8, 2019 PMID: 30955347 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.037885
  214. Pratley RE, Aroda VR, Lingvay I et al Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes & Endocrinology. Jan 31, 2018 PMID: 29397376 http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30024-X/abstract - Tahrani AA, Bellary S, Barnett AH. Once-weekly GLP-1R agonists: moving the goal posts. Lancet Diabetes & Endocrinology. Jan 31, 2018 PMID: 29397375 http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30049-4/fulltext
  215. Rosenstock J, Allison D, Birkenfeld AL et al Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With SulfonylureaThe PIONEER 3 Randomized Clinical Trial. JAMA. 2019;321(15):1466-1480. https://jamanetwork.com/journals/jama/fullarticle/2729339
  216. Reaven PD et al Intensive Glucose Control in Patients with Type 2 Diabetes - 15-Year Follow-up. N Engl J Med 2019; 380:2215-2224. June 6, 2019 PMID: 31167051 https://www.nejm.org/doi/full/10.1056/NEJMoa1806802
  217. Gerstein HC, Colhoun HM, Dagenais GR et al Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. June 8, 2019 PMID: 31189511 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31149-3/fulltext - Gerstein HC, Colhoun HM, Dagenais GR et al Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Lancet. June 8, 2019 PMID: 31189509 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31150-X/fulltext
  218. American Diabetes Association. Living Standards of Medical Care in Diabetes. Diabetes Care 2019. June 3, http://care.diabetesjournals.org/living-standards#June/%203
  219. Andersen YMF, Egeberg A, Ban L et al. Association Between Topical Corticosteroid Use and Type 2 Diabetes in Two European Population-Based Adult Cohorts. Diabetes Care. 2019 Jun;42(6):1095-1103 PMID: 30936111 http://care.diabetesjournals.org/content/42/6/1095
  220. Suissa S et al. Inhaled corticosteroids and the risks of diabetes onset and progression. Am J Med 2010 Nov; 123:1001. PMID: 20870201
  221. Jiao J, Liu G, Shin HJ et al Dietary fats and mortality among patients with type 2 diabetes: analysis in two population based cohort studies. BMJ 2019;366:l4009 PMID: 31266749 Free Articl https://www.bmj.com/content/366/bmj.l4009
  222. Pratley R, Amod A, Hoff ST et al. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): A randomised, double-blind, phase 3a trial. Lancet 2019 Jul 6; 394:39. PMID: 31186120 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31271-1/fulltext - Holst JJ. Which to choose, an oral or an injectable glucagon-like peptide-1 receptor agonist? Lancet 2019 Jul 6; 394:4. PMID: 31186119 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31350-9/fulltext
  223. NEJM Knowledge+ Question of the Week. July 30, 2019 https://knowledgeplus.nejm.org/question-of-week/868/ - Inzucchi SE. Clinical practice. Diagnosis of diabetes. N Engl J Med 2012 Aug 10; 367:542-550 PMID: 22873534 https://www.nejm.org/doi/full/10.1056/NEJMcp1103643
  224. Roumie CL, Chipman J, Min JY et al Metformin vs Sulfonylurea With Major Adverse Cardiovascular Events Among Patients With Diabetes and Reduced Kidney Function. JAMA. Published online September 19, 2019. PMID: 31536102 https://jamanetwork.com/journals/jama/fullarticle/2751397 - Wexler DJ Sulfonylureas and Cardiovascular SafetyThe Final Verdict? JAMA. Published online September 19, 2019. PMID: 31536110 https://jamanetwork.com/journals/jama/fullarticle/2751396
  225. Lingvay I, Catarig AM, Frias JP et al Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): a double-blind, phase 3b, randomised controlled trial. Lancet Diabetes & Endocrinology. Sept 17, 2019 PMID: 3154086 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30311-0/fulltext - Scheen AJ SGLT2 inhibitor or GLP-1 receptor agonist in type 2 diabetes? Lancet Diabetes & Endocrinology. Sept 17, 2019 PMID: 31540866 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30310-9/fulltext
  226. Weiner JZ, Gopalan A, Mishra P et al. Use and discontinuation of insulin treatment among adults aged 75 to 79 years with type 2 diabetes. JAMA Intern Med 2019 Sep 23 PMID: 31545376
  227. de Boer IH, Zelnick LR, Ruzinski J et al Effect of Vitamin D and Omega-3 Fatty Acid Supplementation on Kidney Function in Patients With Type 2 Diabetes. A Randomized Clinical Trial. JAMA. Published online November 8, 2019. PMID: 31703120 https://jamanetwork.com/journals/jama/article-abstract/2755300 - Lucas A, Wolf M Vitamin D and Health Outcomes. Then Came the Randomized Clinical Trials. JAMA. Published online November 8, 2019. PMID: 31703117 https://jamanetwork.com/journals/jama/fullarticle/2755297
  228. Buse JB, Wexler DJ, Tsapas A et al 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2019 Dec; PMID: 31857443 https://care.diabetesjournals.org/content/early/2019/12/18/dci19-0066 - Summary of Revisions: Standards of Medical Care in Diabetes - 2020 Diabetes Care 2020 Jan; 43(Supplement 1): S4-S6. PMID: 31862743 https://care.diabetesjournals.org/content/43/Supplement_1/S4?etoc=
  229. George J A Diabetes Drug That Slows Cognitive Decline? - Trulicity analysis hints at dementia prevention MedPage Today June 22, 2020 https://www.medpagetoday.com/neurology/dementia/87188 - Nackerdien Z Could a Diabetes Drug Reduce Cognitive Impairment? - Long-term treatment with a GLP-1 receptor agonist shows promise. MedPage Today Jukly 5, 2020 https://www.medpagetoday.org/neurology/dementia/87395 - Cukierman-Yaffe T, et al Effect of dulaglutide on cognitive impairment in type 2 diabetes: an exploratory analysis of the REWIND trial. Lancet Neurology, Volume 19, ISSUE 7, P582-590, July 01, 2020 https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30173-3/fulltext - Biessels, GJ A first lead in dementia prevention in people with diabetes. Lancet Neurology, Volume 19, ISSUE 7, P559-560, July 01, 2020 https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30174-5/fulltext
  230. Tsapas A et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes: A systematic review and network meta-analysis. Ann Intern Med 2020 Jun 30; PMID: 32598218 https://www.acpjournals.org/doi/10.7326/M20-0864
  231. Writing Committee, Das SR, Everett BM, Birtcher KK et al 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes. A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. August 2020 PMID: 32771263 https://www.onlinejacc.org/content/early/2020/07/27/j.jacc.2020.05.037
  232. Doyle-Delgado K et al. Pharmacologic approaches to glycemic treatment of type 2 diabetes: Synopsis of the 2020 American Diabetes Association's standards of medical care in diabetes clinical guideline. Ann Intern Med 2020 Sep 1; PMID: 32866414 Free article. https://www.acpjournals.org/doi/10.7326/M20-2470
  233. Singh LG et al. Reducing inpatient hypoglycemia in the general wards using real-time continuous glucose monitoring: The glucose telemetry system, a randomized clinical trial. Diabetes Care 2020 Aug 5 PMID: 32759361 https://care.diabetesjournals.org/content/early/2020/08/04/dc20-0840
  234. Komorita Y, Iwase M, Fujii H et al Additive effects of green tea and coffee on all-cause mortality in patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. BMJ Open Diabetes Res Care. 2020 Oct;8(1):e001252 PMID: 33087342 PMCID: PMC7577036 Free PMC article https://drc.bmj.com/content/8/1/e001252
  235. Lingvay I, Capehorn MS, Catarig AM et al. Efficacy of once-weekly semaglutide vs empagliflozin added to metformin in type 2 diabetes: Patient-level meta-analysis. J Clin Endocrinol Metab 2020 Dec; 105:dgaa57 PMID: 32827435 Free PMC article https://academic.oup.com/jcem/article/105/12/dgaa577/5896001
  236. Bradley MC et al. Severe hypoglycemia risk with long-acting insulin analogs vs neutral protamine Hagedorn insulin. JAMA Intern Med 2021 Mar 1; [e-pub]. PMID: 33646277 PMCID: PMC7922234 (available on 2022-03-01) https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2777049
  237. Barbiellini Amidei C et al. Association between age at diabetes onset and subsequent risk of dementia. JAMA 2021 Apr 27; 325:1640. PMID: 33904867 https://jamanetwork.com/journals/jama/article-abstract/2779197
  238. Giugliano D et al. Feasibility of simplification from a basal-bolus insulin regimen to a fixed-ratio formulation of basal insulin plus a GLP-1RA or to basal insulin plus an SGLT2 inhibitor: BEYOND, a randomized, pragmatic trial. Diabetes Care 2021 Jun; 44:1353 PMID: 33883195 https://care.diabetesjournals.org/content/44/6/1353
  239. Xie Y, Bowe B, Gibson AK et al Comparative Effectiveness of Sodium-Glucose Cotransporter 2 Inhibitors vs Sulfonylureas in Patients With Type 2 Diabetes. JAMA Intern Med. Published online June 28, 2021. PMID: 34180939 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2781475
  240. Talebraza S et al Geriatrics Evaluation & Management Tools American Geriatrics Society. 2021 https://geriatricscareonline.org/ProductAbstract/geriatrics-evaluation-management-tools/B007/
  241. George J Diabetes Drug Linked With Less Brain Amyloid. People with diabetes on DPP-4 inhibitors also showed slower cognitive decline. MedPage Today August 11, 2021 https://www.medpagetoday.com/neurology/alzheimersdisease/93999 - Jeong SH, Kim HR, Kim J et al Association of dipeptidyl peptidase-4 inhibitor use and amyloid burden in diabetic patients with AD-related cognitive impairment. Neurology 2021. Aug 11. PMID: 34380754 https://n.neurology.org/content/early/2021/08/11/WNL.0000000000012534
  242. Ried-Larsen M, Rasmussen MG, Blond K et al. Association of cycling with all-cause and cardiovascular disease mortality among persons with diabetes: The European Prospective Investigation into Cancer and Nutrition (EPIC) study. JAMA Intern Med 2021 Jul 19; [e-pub]. PMID: 34279548 PMCID: PMC8290339 (available on 2022-07-19) https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2782014 - Redberg RF, Vittinghoff E, Katz MH. Cycling for health. JAMA Intern Med 2021 Jul 19; [e-pub] PMID: 34279558 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2782022
  243. Migdal AL et al. Inpatient glycemic control with sliding scale insulin in noncritical patients with type 2 diabetes: Who can slide? J Hosp Med 2021 Aug; 16:462. PMID: 34328842 https://www.journalofhospitalmedicine.com/jhospmed/article/242995/hospital-medicine/inpatient-glycemic-control-sliding-scale-insulin - Pasquel FJ, Umpierrez GE. Annals for hospitalists inpatient notes: How we treat hyperglycemia in the hospital. Ann Intern Med. 2018 Jan 16;168(2):HO2-HO3. PMID: 34399081 https://www.acpjournals.org/doi/10.7326/M21-2789
  244. Grundy SM, Stone NJ, Bailey AL et al 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1046-e1081. PMID: 30565953
  245. Patorno E, Htoo PT, Glyn RJ et al. Sodium-glucose cotransporter-2 inhibitors versus glucagon-like peptide-1 receptor agonists and the risk for cardiovascular outcomes in routine care patients with diabetes across categories of cardiovascular disease. Ann Intern Med 2021 Sep 28; [e-pub] PMID: 34570599 https://www.acpjournals.org/doi/10.7326/M21-0893
  246. Zoler ML New Type 2 Diabetes Treatment Shows Promise in First Human Study. Medscape. November 18, 2021 https://www.medscape.com/viewarticle/963229
  247. Nazarzadeh M, Bidel Z, Canoy D et al. Blood pressure lowering and risk of new-onset type 2 diabetes: An individual participant data meta-analysis. Lancet 2021 Nov 13; 398:1803. PMID: 34774144 PMCID: PMC8585669 Free PMC article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01920-6/fulltext
  248. Lowry F The Best Statins to Lower Non-HDL Cholesterol in Diabetes? Medscsape. April 13, 2022 https://www.medscape.com/viewarticle/972109 - Hodkinson A, Tsimpida D, Kontopantelis E et al Comparative effectiveness of statins on non-high density lipoprotein cholesterol in people with diabetes and at risk of cardiovascular disease: systematic review and network meta-analysis. BMJ 2022;376:e067731 PMID: 35331984 PMCID: PMC8943592 Free PMC article
  249. Tucker ME SGLT-2 inhibitors as First-Line Therapy in Type 2 Diabetes? Medscape. May 23, 2022 https://www.medscape.com/viewarticle/974463 - Shin H et al Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors Versus Metformin. A Cohort Study. Ann Intern Med 2022. May 24 PMID: 35605236 https://www.acpjournals.org/doi/10.7326/M21-4012
  250. Shin H et al. Cardiovascular outcomes in patients initiating first-line treatment of type 2 diabetes with sodium-glucose cotransporter-2 inhibitors versus metformin: A cohort study. Ann Intern Med 2022 May 24; [e-pub]. PMID: 35605236 https://www.acpjournals.org/doi/10.7326/M21-4012
  251. Le P et al. Adherence to the American Diabetes Association's glycemic goals in the treatment of diabetes among older Americans, 2001-2018. Diabetes Care 2022 May; 45:1107. PMID: 35076695 https://diabetesjournals.org/care/article-abstract/45/5/1107/141006/Adherence-to-the-American-Diabetes-Association-s - Pilla SJ et al. Individualized glycemic goals for older adults are a moving target. Diabetes Care 2022 May; 45:1029 PMID: 35561130 https://diabetesjournals.org/care/article/45/5/1029/146877/Individualized-Glycemic-Goals-for-Older-Adults-Are
  252. The GRADE Study Research Group. Glycemia reduction in type 2 diabetes - Microvascular and cardiovascular outcomes. N Engl J Med 2022 Sep 22; 387:1075 PMID: 36129997 https://www.nejm.org/doi/10.1056/NEJMoa2200436 - The GRADE Study Research Group. Glycemia reduction in type 2 diabetes - Glycemic outcomes. N Engl J Med 2022 Sep 22; 387:1063 PMID: 36129996 https://www.nejm.org/doi/10.1056/NEJMoa2200433 - Wexler DJ et al. Comparative effects of glucose-lowering medications on kidney outcomes in type 2 diabetes: The GRADE randomized clinical trial. JAMA Intern Med 2023 May 22; [e-pub]. PMID: 37213109 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804683
  253. Vellanki P et al. Efficacy and safety of intensive versus nonintensive supplemental insulin with a basal-bolus insulin regimen in hospitalized patients with type 2 diabetes: A randomized clinical study. Diabetes Care 2022 Oct; 45:2217-2223. PMID: 35675498 https://diabetesjournals.org/care/article/45/10/2217/147066/Efficacy-and-Safety-of-Intensive-Versus
  254. Shields BM, Angwin CD, Shepherd MH et al Patient preference for second- and third-line therapies in type 2 diabetes: a prespecified secondary endpoint of the TriMaster study. Nature Medicine. 2022. Dec 7 PMID: 36477734 https://www.nature.com/articles/s41591-022-02121-6
  255. Tucker ME ADA Advises New BP, Lipid Targets for People With Diabetes. Medscape. Dec 13, 2022 https://www.medscape.com/viewarticle/985482 - ElSayed NA, Aleppo G, Aroda VR et al 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2023 Diabetes Care. 2023 Jan 1;46(Suppl 1):S158-S190. PMID: 36507632 PMCID: PMC9810475 Free PMC article
  256. Busko M More Type 2 Diabetes Deaths From Cancer Than Heart Disease. Medscape. Jan 26, 2023 https://www.medscape.com/viewarticle/987534 - Ling S, Zaccardi F, Issa E et al Inequalities in cancer mortality trends in people with type 2 diabetes: 20 year population-based study in England. Diabetologia. 2023. Jan 24. PMID: 36690836 https://link.springer.com/article/10.1007/s00125-022-05854-8
  257. Monaco K Old Drug May Help Protect People With Diabetes Against Dementia. Those with history of ischemic heart disease or stroke saw greatest protection with pioglitazone. MedPage Today February 15, 2023 https://www.medpagetoday.com/neurology/dementia/103123 - Ha J, Choi DW, Kim, Kim KY, Nam CM, Kim E. Pioglitazone Use and Reduced Risk of Dementia in Patients With Diabetes Mellitus With a History of Ischemic Stroke. Neurology. 2023. Feb 15 PMID: 36792375 https://n.neurology.org/content/early/2023/02/15/WNL.0000000000207069
  258. Monaco K 'Relaxed' A1c OK for Mitigating Dementia Risk in Older Diabetes Patients. Keeping most readings under 9% avoided elevated dementia risk. MedPage Today April 17, 2023 https://www.medpagetoday.com/endocrinology/diabetes/104062 - Moran, C, Lacy, ME, Whitmer RA et al Glycemic Control Over Multiple Decades and Dementia Risk in People With Type 2 Diabetes. JAMA Neurol. Published online April 17, 2023 PMID: 37067815 https://jamanetwork.com/journals/jamaneurology/article-abstract/2803244
  259. Ma L et al. Beverage consumption and mortality among adults with type 2 diabetes: Prospective cohort study. BMJ 2023 Apr 19; 381:e073406. PMID: 37076174 PMCID: PMC10114037 Free PMC article https://www.bmj.com/content/381/bmj-2022-073406
  260. NEJM Knowledge+ Endocrinology
  261. Pilla SJ et al. A national physician survey of deintensifying diabetes medications for older adults with type 2 diabetes. Diabetes Care 2023 Jun; 46:1164 PMID: 36800554 PMCID: PMC10234750 (available on 2024-06-01) https://diabetesjournals.org/care/article-abstract/46/6/1164/148459/A-National-Physician-Survey-of-Deintensifying
  262. Youmshajekian L Apple Cider Vinegar, Fenugreek Best Herbal Remedies for T2D. Medscape. August 25, 2023 https://www.medscape.com/viewarticle/apple-cider-vinegar-fenugreek-best-herbal-remedies-t2d-2023a1000jt0
  263. Sacks DB et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care 2023 Oct 1; 46:e151. PMID: 37471273 PMCID: PMC10516260 (available on 2024-10-01)
  264. Gu X et al Red meat intake and risk of type 2 diabetes in a prospective cohort study of United States females and males. Am J Clin Nutr 2023, Oct 19. PMID: 38044023 PMCID: PMC10739777 (available on 2024-10-19) https://www.sciencedirect.com/science/article/abs/pii/S0002916523661192
  265. McCall B Common Meds Link to Sudden Cardiac Arrest in Type 2 Diabetes. Medscape. October 23, 2023 https://www.medscape.com/viewarticle/997629
  266. Sun M, Chen WM, W SY, Zhang J Metformin in elderly type 2 diabetes mellitus: dose-dependent dementia risk reduction. Brain. 2023. Oct 25:awad366 PMID: 37878862 https://academic.oup.com/brain/advance-article-abstract/doi/10.1093/brain/awad366/7329837
  267. Zimmerman SC et al Metformin Cessation and Dementia Incidence. JAMA Netw Open. 2023;6(10):e2339723. PMID: 37878309 PMCID: PMC10600586 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810994
  268. Rosenctock J, Frias JP, Rodbard HW et al Tirzepatide vs Insulin Lispro Added to Basal Insulin in Type 2 Diabetes. The SURPASS-6 Randomized Clinical Trial. JAMA. 2023;330(17):1631-1640 PMID: 37786396 PMCID: PMC10548360 (available on 2024-04-03) https://jamanetwork.com/journals/jama/fullarticle/2810386
  269. Korytkowski MT et al. Management of hyperglycemia in hospitalized adult patients in non-critical care settings: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2022 Aug; 107:2101 PMID: 35690958 PMCID: PMC9653018 Free PMC article https://academic.oup.com/jcem/article/107/8/2101/6605637
  270. ElSayed NA, Aleppo G, Aroda VR, et al. 16. Diabetes care in the hospital: standards of care in diabetes - 2023. Diabetes Care. 2023;46:S267-S278. PMID: 36507644 PMCID: PMC9810470 Free PMC article
  271. Joseph JJ, Deedwania P, Acharya T et al & the American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; and Council on Hypertension. Comprehensive Management of Cardiovascular Risk Factors for Adults With Type 2 Diabetes: A Scientific Statement From the American Heart Association. Circulation. 2022 Mar;145(9):e722-e759. PMID: 35000404 Free article. Review.
  272. Kirkman MS, Tripputi M, Krause-Steinrauf H, et al. Comparative Effects of Randomized Second-line Therapy for Type 2 Diabetes on a Composite Outcome Incorporating Glycemic Control, Body Weight, and Hypoglycemia: An Analysis of Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care. 2024 Jan 9:dc231332. PMID: 38194519
  273. Leung E, Wongrakpanich S, Munshi MN. Diabetes Management in the Elderly. Diabetes Spectr. 2018 Aug;31(3):245-253. PMID: 30140140 Free PMC article.
  274. Courcoulas AP et al. Long-term outcomes of medical management vs bariatric surgery in type 2 diabetes. JAMA 2024 Feb 27; 331:654. PMID: 38411644 PMCID: PMC10900968 Free PMC article https://jamanetwork.com/journals/jama/fullarticle/2815401
  275. Green JB, Everett BM, Ghosh A, et al. Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study). Circulation. 2024 Feb 12 PMID: 38344820
  276. Qaseem A, Obley AJ, Shamliyan T et al Newer Pharmacologic Treatments in Adults With Type 2 Diabetes: A Clinical Guideline From the American College of Physicians. Ann Intern Med. 2024 Apr 19. PMID: 38639546 - American College of Physicians (ACP) Newer Pharmacologic Treatments in Adults With Type 2 Diabetes: A Visual Clinical Guideline From the American College of Physicians. Ann Intern Med. 2024 Apr 19:eM240803. PMID: 38639540 https://acp.gradepro.org/presentations/#/vi_guidelines/p_99337b96-b16d-5781-96d0-5c173813f842_a6c5dbd3-d02e-4ee3-98c4-8f4415bdbe03-acp_visual_guidelines_0d978ddd-c64c-40eb-b70a-6b00623578ca-23
  277. Gibson AA, Cox E, Schneuer FJ et al Sex differences in risk of incident microvascular and macrovascular complications: a population-based data-linkage study among 25 713 people with diabetes. J Epidemiol Community Health. 2024 May 16:jech-2023-221759. PMID: 38755015 Free article https://jech.bmj.com/content/early/2024/04/17/jech-2023-221759
  278. Perkovic V et al Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024. May 23 PMID: 38785209 https://www.nejm.org/doi/full/10.1056/NEJMoa2403347
  279. Adler AI, Coleman RL, Leal J et al. Post-trial monitoring of a randomised controlled trial of intensive glycaemic control in type 2 diabetes extended from 10 years to 24 years (UKPDS 91). Lancet 2024 May 17; [e-pub] PMID: 38772405 Free article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00537-3/fulltext
  280. Bidulka P, Lugo-Palacios DG, Carroll O, et al. Comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus: Emulation of a target trial using routinely collected health data. BMJ 2024 May 8; 385:e077097. PMID: 38719492 PMCID: PMC11077536 Free PMC article.
  281. Fu EL et al. SGLT-2 inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors and risk of hyperkalemia among people with type 2 diabetes in clinical practice: Population based cohort study. BMJ 2024 Jun 26; 385:e078483. PMID: 38925801 PMCID: PMC11200155 Free PMC article https://www.bmj.com/content/385/bmj-2023-078483
  282. Tian S, Guo T, Qian F et al Fish Oil, Plasma n-3 PUFAs, and Risk of Macro- and Microvascular Complications among Individuals with Type 2 Diabetes. J Clin Endocrinol Metab. 2024 Jul 12:dgae482. PMID: 38994586
  283. Wu J, Li T, Guo M et al Treating a type 2 diabetic patient with impaired pancreatic islet function by personalized endoderm stem cell-derived islet tissue. Cell Discov. 2024 Apr 30;10(1):45. PMID: 38684699 PMCID: PMC11058776 Free PMC article. No abstract available.
  284. McCall B Type 2 Diabetes: Insulin-Free for 24 Months After Novel Endoscopic Procedure. Medscape. Oct 15, 2024 https://www.medscape.com/viewarticle/type-2-diabetes-insulin-free-24-months-after-novel-2024a1000ito
  285. Sakamoto K, Butera MA, Zhou C et al. Overnutrition causes insulin resistance and metabolic disorder through increased sympathetic nervous system activity. Cell Metab. 2024 Oct 15:S1550-4131(24)00376-0 PMID: 39437790 https://www.sciencedirect.com/science/article/abs/pii/S1550413124003760
  286. Chaput JP, Biswas RK, Ahmadi M et al Sleep Irregularity and the Incidence of Type 2 Diabetes: A Device-Based Prospective Study in Adults. Diabetes Care. 2024 Oct 10:dc241208. PMID: 39388339
  287. Liu L, Ke W, Li H Intense simplified strategy for newly diagnosed type 2 diabetes in patients with severe hyperglycaemia: multicentre, open label, randomised trial. BMJ. 2024 Oct 15;387:e080122. PMID: 39406449 PMCID: PMC11474422 Free PMC article. Clinical Trial. https://www.bmj.com/content/387/bmj-2024-080122