Intensive Therapy

Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy.

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Exclusive! Expert commentary webcast from Vivian Fonseca, MD, on this post-hoc analysis of ADVANCE. Morton J, Zoungas S, Li Q, et al; on behalf of the ADVANCE Collaborative Group. Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy. Diabetes Care. 2012;35:2201-2206. Macro- and microvascular complications remain significant concerns in the treatment of patients with type 2 diabetes.

Progression of vascular calcification is increased with statin use in the Veterans Affairs Diabetes Trial (VADT).

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Exclusive! Expert commentary webcast from Vivian Fonseca, MD, on this post-hoc analysis of VADT. Saremi A, Bahn G, Reaven PD; for the VADT Investigators. Progression of vascular calcification is increased with statin use in the Veterans Affairs Diabetes Trial (VADT). Diabetes Care. 2012;35:2390-2392. Cross-sectional data from the Veterans Affairs Diabetes Trial (VADT) showed that participants with coronary artery or abdominal aortic calcification had an increased prevalence of cardiovascular disease, including peripheral artery disease and coronary artery disease.

Health benefits of gastric bypass surgery after 6 years

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Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308(11):1122-1131. This prospective study by Adams and colleagues explored the weight loss and cardiometabolic benefits of Roux-en-Y gastric bypass (RYGB) among severely obese patients over 6 years of follow-up.

Do statins interfere with lifestyle intervention in the prevention of diabetes in primary healthcare? One-year follow-up of the FIN-D2D project

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Rautio N, Jokelainen J, Oksa H, et al. Do statins interfere with lifestyle intervention in the prevention of diabetes in primary healthcare? One-year follow-up of the FIN-D2D project. BMJ Open. 2012;2(5). pii: e001472. doi: 10.1136/bmjopen-2012-001472. Treatment with statins has been linked to an increased risk for type 2 diabetes in several post-hoc evaluations of previous completed trials, leading to controversy regarding the risk/benefit profile of statin therapy for primary prevention in patients who are at low risk for developing cardiovascular (CV) events.

Four-year weight losses in the Look AHEAD study: factors associated with long-term success

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Alert: October 20, 2012: The Look AHEAD trial has been halted due to futility. Read exclusive commentary from Anne Peters, MD, one of the study’s principal investigators, on the important role of lifestyle interventions for preventing obesity and diabetes despite the lack of CV benefit seen in the trial. Wadden TA, Neiberg RH, Wing RR, et al; for the Look AHEAD Research Group. Four-year weight losses in the Look AHEAD study: factors associated with long-term success. Obesity. 2011;19(10):1987-1998. This analysis of 4-year data from the Look AHEAD (Action for Health in Diabetes) trial examined the effect of lifestyle on weight loss and identified demographic characteristics and lifestyle behaviors associated with sustained weight loss in the intensive lifestyle intervention treatment group.

Effects of gastric bypass surgery in patients with type 2 diabetes and only mild obesity

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Cohen RV, Pinheiro JC, Schiavon CA, Salles JE, Wajchenberg BL, Cummings DE. Effects of gastric bypass surgery in patients with type 2 diabetes and only mild obesity. Diabetes Care. 2012;35:1420-1428. The authors of the current prospective study sought to examine the potential benefits of laparoscopic Roux-en-Y gastric bypass (LRYGB) among those with BMI 30-34.9 kg/m2 (class I obesity) and type 2 diabetes.

Effects of intensive blood-pressure control in type 2 diabetes mellitus.

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ACCORD Study Group, Cushman WC, Evans GW, Byington RP, et al. Effects of intensive blood pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362(17):1575-1585. The blood-pressure (BP) arm of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study evaluated the effects of intensive BP-control on cardiovascular disease (CVD) events among high-risk subjects with type 2 diabetes.

Effects of intensive glucose lowering in type 2 diabetes

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The Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545-2559. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study investigated the effects of intensive glucose-lowering therapy on CV event reduction among patients with type 2 diabetes and either risk factors for, or established, cardiovascular disease.

β-cell function preservation after 3.5 years of intensive diabetes therapy

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Harrison LB, Adams Huet B, Raskin P, Lingvay I. Beta cell function preservation after 3.5 years of intensive diabetes therapy. Diabetes Care. 2012;35(7):1406-1412. To assess beta-cell function preservation after 3.5 years of intensive therapy with insulin plus metformin (INS group) versus triple oral therapy (TOT group) with metformin, glyburide, and pioglitazone.

Assessing Vascular Disease Risk Associated with Medication-Related Hypoglycemia

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Exclusive! Expert video from Burton E. Sobel, MD, on the debate over intensive vs somewhat less intensive glycemic control in the context of this study. Zhao Y, Campbell CR, Fonseca V, Shi L. Assessing Vascular Disease Risk Associated with Medication-Related Hypoglycemia. Diabetes Care. 2012;35(5):1126-1132. Zhao and colleagues examined the impact of hypoglycemia associated with antihyperglycemic medications on vascular risk among veterans with type 2 diabetes in a retrospective cohort study.

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