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NEWS - Endocrinology

Statins for primary prevention of cardiovascular events and mortality in old and very old adults with and without type 2 diabetes: retrospective cohort study – The BMJ (free)

Editorial: Primary prevention with statins for older adults (free)

Commentaries: Expert reaction to study on use of statins in older people – Science Media Centre (free) AND Widespread use of statins in healthy older people to prevent heart disease not recommended in new study – BMJ, via ScienceDaily (free)

“New research does not support widespread use of statins in healthy older people to prevent heart disease and stroke. Results found that any protective effect was limited to those with type 2 diabetes aged between 75 and 84” (via @bmj_latest see Tweet)

 


Metformin and Risk of Hypertension in Taiwanese Patients With Type 2 Diabetes Mellitus – Journal of the American Heart Association (free)

“A reduced risk of hypertension is observed in metformin users in a dose‐response pattern”.

 


Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials – The Lancet (free)

Commentaries: Weight-adjusted aspirin for cardiovascular prevention – The Lancet (free) AND One dose of aspirin doesn’t fit all – University of Oxford (free)

Practice Changing Article. “Low doses of aspirin (75–100 mg) were only effective in preventing vascular events in patients weighing less than 70 kg, and had no benefit in the 80% of men and nearly 50% of all women weighing 70 kg or more. By contrast, higher doses of aspirin were only effective in patients weighing 70 kg or more.”

 


Seriously, Juice Is Not Healthy – The New York Times (10 articles per month are free)

“Would you take a multivitamin if it contained 10 teaspoons of sugar? No. Then why are you drinking juice?” (via @NYTHealth see Tweet)

 


Metformin exposure in first trimester of pregnancy and risk of all or specific congenital anomalies: exploratory case-control study – The BMJ (free)

In this large international, population-based database, no evidence was found of an overall increased risk of congenital anomalies after first trimester metformin exposure.

 


Association of Initiation of Basal Insulin Analogs vs Neutral Protamine Hagedorn Insulin With Hypoglycemia-Related Emergency Department Visits or Hospital Admissions and With Glycemic Control in Patients With Type 2 Diabetes – JAMA (free for a limited period)

Editorial: Revisiting NPH Insulin for Type 2 Diabetes: Is a Step Back the Path Forward? (free for a limited period)

Clinical Review Audio: Health Care Spending Gone Wild: Using Expensive Insulin Analogs With Few Clinical Advantages (free)

“Long-acting insulin analogs not associated with reduced hypoglycemia-related ED visits or hospital admissions when compared with NPH insulin, despite costing 5-10x as much” (via @jsross119 see Tweet)

 


Prognostic Implications of Single-Sample Confirmatory Testing for Undiagnosed Diabetes: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Diagnosing Diabetes From a Single Blood Sample – Johns Hopkins Bloomberg School of Public Health, via NewsWise (free) AND One Blood Test Might Be Enough to Diagnosis – HealthDay (free) AND Diabetes Dx Predicted Accurately with Single Blood Sample – MedPage Today (free registration required)

“The standard practice of repeat blood tests may not always be necessary, a new study suggests” (from Johns Hopkins Bloomberg School of Public Health)

 


The association between food insecurity and incident type 2 diabetes in Canada: A population-based cohort study – PLOS One (free)

Commentary: Food insecurity linked to type 2 diabetes risk – Reuters (free)

“Canadians who cannot afford to eat regularly or to eat a healthy diet have more than double the average risk of developing type 2 diabetes” (from Reuters)

 


A1C Targets Should Be Personalized to Maximize Benefits While Limiting Risks – Diabetes Care (free) (via @Abraham_RMI)

Related guideline: 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 (free)

“Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes” (from ACP Guideline, prompting the Editorial)

 


High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial – Circulation (free)

With a median follow-up of 3.9 years, high-dose as compared with low-dose pitavastatin significantly reduced the risk of the primary end point (4.3% vs 5.4%; NNT = 90), a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization.

 



Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis – JAMA (link to abstract – $ for full-text)

Commentaries: Patients With Highest LDL Levels Benefit Most From Lipid-Lowering Drugs – MedicalResearch.com (free) AND New Study Finds that Statins Prevent Cardiovascular Deaths – Science Based Medicine (free) AND Meta-Analysis: ‘Floor’ for Lipid-Lowering Mortality Benefits May Be Real – MedPage Today (free registration required)

“In meta-analyses of LDL-C lowering drug trials, we found that total and cardiovascular mortality were reduced only when the mean baseline LDL-C in the trial was >100 mg/dl” (from MedicalResearch.com)

 


What We Know (and Don’t Know) About How to Lose Weight – The New York Times (10 articles per month are free)

“One conclusion from a much-discussed study: The best diet is the one you can stick to”.

 


#ACC18 – The ODYSSEY Trial Ends Well— But Will It Be Enough? – Cardiobrief (free) AND Ten Quick Thoughts on ODYSSEY – John Mandrola, via Medscape (free registration required)

“An absolute risk reduction of 1.6% in the primary endpoint translates to a number needed to treat of 64. Using the current price of $14,500 per year, Kaul calculated that preventing one event over the trial period of almost 3 years would cost about $2.6 million” (via John Mandrola). This study was presented at #ACC18 and has not been published yet. Among the many commentaries, these two were selected for a balanced point of view.

 


Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: a systematic review and meta-analysis – Diabetes Research and Clinical Practice (link to abstract – $ for full-text)

“Carbohydrate-restricted diets, associated with reductions in HbA1c of around 0.4% in short term” (via @kamleshkhunti see Tweet)

 


It’s poverty, not individual choice, that is driving extraordinary obesity level – The Conversation (free)

“Statistics point remorselessly towards obesity being a symptom with an underlying social cause”.

 


Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial – The Lancet (link to abstract – $ for full-text)

The mean number of hypoglycemic events per 28 days was reduced from 10.8 to 3.5 among patients in the continuous glucose monitoring group and from 14.4 to 13.7 among control group participants.

 


Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies – Progress in Neuro-Psychopharmacology and Biological Psychiatry (link to abstract – $ for full-text) (via @psychopharmacol see Tweet)

“These findings provide preliminary evidence that atypical antipsychotics cause insulin resistance and weight gain directly, independent of psychiatric disease and may be associated with length of treatment”.

 


Risk of pre-eclampsia in women taking metformin: a systematic review and meta-analysis – Diabetic Medicine (free)

Source: ACP Journal Wise ($)

“Metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin”

 


Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals – JAMA Cardiology (free)

Commentary: Omega-3 Supplements Don’t Protect Against Heart Disease – The New York Times (10 articles per month are free)

Omega-3 fatty acids did not prevent fatal or nonfatal coronary heart disease or any major vascular events.

 


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