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The Lancet Diabetes and Endocrinology
Journal Prestige (SJR): 9.705
Citation Impact (citeScore): 6
Number of Followers: 192  
 
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ISSN (Online) 2213-8587
Published by Elsevier Homepage  [3182 journals]
  • The Slow Moon Climbs: The Science, History, and Meaning of Menopause,
           Susan P Mattern. Princeton University Press (2019), 480, £25·00, ISBN:
           978-0691171630
    • Abstract: Publication date: Available online 7 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Fiona Mitchell
       
  • Research digest: pioneering an oral GLP-1 receptor agonist
    • Abstract: Publication date: Available online 6 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Mark A Atkinson, Alvin C Powers
       
  • Odanacatib: the best osteoporosis treatment we never had'
    • Abstract: Publication date: Available online 31 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Louise A Statham, Terry J Aspray
       
  • Bariatric surgery and type 2 diabetes: a step closer to defining an
           optimal approach
    • Abstract: Publication date: Available online 31 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Paul O'Brien
       
  • Odanacatib for the treatment of postmenopausal osteoporosis: results of
           the LOFT multicentre, randomised, double-blind, placebo-controlled trial
           and LOFT Extension study
    • Abstract: Publication date: Available online 31 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Michael R McClung, Michelle L O'Donoghue, Socrates E Papapoulos, Henry Bone, Bente Langdahl, Kenneth G Saag, Ian R Reid, Douglas P Kiel, Ilaria Cavallari, Marc P Bonaca, Stephen D Wiviott, Tobias de Villiers, Xu Ling, Kurt Lippuner, Toshitaka Nakamura, Jean-Yves Reginster, Jose Adolfo Rodriguez-Portales, Christian Roux, José Zanchetta, Cristiano A F ZerbiniSummaryBackgroundOdanacatib, a cathepsin K inhibitor, reduces bone resorption while maintaining bone formation. Previous work has shown that odanacatib increases bone mineral density in postmenopausal women with low bone mass. We aimed to investigate the efficacy and safety of odanacatib to reduce fracture risk in postmenopausal women with osteoporosis.MethodsThe Long-term Odanacatib Fracture Trial (LOFT) was a multicentre, randomised, double-blind, placebo-controlled, event-driven study at 388 outpatient clinics in 40 countries. Eligible participants were women aged at least 65 years who were postmenopausal for 5 years or more, with a femoral neck or total hip bone mineral density T-score between −2·5 and −4·0 if no previous radiographic vertebral fracture, or between −1·5 and −4·0 with a previous vertebral fracture. Women with a previous hip fracture, more than one vertebral fracture, or a T-score of less than −4·0 at the total hip or femoral neck were not eligible unless they were unable or unwilling to use approved osteoporosis treatment. Participants were randomly assigned (1:1) to either oral odanacatib (50 mg once per week) or matching placebo. Randomisation was done using an interactive voice recognition system after stratification for previous radiographic vertebral fracture, and treatment was masked to study participants, investigators and their staff, and sponsor personnel. If the study completed before 5 years of double-blind treatment, consenting participants could enrol in a double-blind extension study (LOFT Extension), continuing their original treatment assignment for up to 5 years from randomisation. Primary endpoints were incidence of vertebral fractures as assessed using radiographs collected at baseline, 6 and 12 months, yearly, and at final study visit in participants for whom evaluable radiograph images were available at baseline and at least one other timepoint, and hip and non-vertebral fractures adjudicated as being a result of osteoporosis as assessed by clinical history and radiograph. Safety was assessed in participants who received at least one dose of study drug. The adjudicated cardiovascular safety endpoints were a composite of cardiovascular death, myocardial infarction, or stroke, and new-onset atrial fibrillation or flutter. Individual cardiovascular endpoints and death were also assessed. LOFT and LOFT Extension are registered with ClinicalTrials.gov (number NCT00529373) and the European Clinical Trials Database (EudraCT number 2007-002693-66).FindingsBetween Sept 14, 2007, and Nov 17, 2009, we randomly assigned 16 071 evaluable patients to treatment: 8043 to odanacatib and 8028 to placebo. After a median follow-up of 36·5 months (IQR 34·43–40·15) 4297 women assigned to odanacatib and 3960 assigned to placebo enrolled in LOFT Extension (total median follow-up 47·6 months, IQR 35·45–60·06). In LOFT, cumulative incidence of primary outcomes for odanacatib versus placebo were: radiographic vertebral fractures 3·7% (251/6770) versus 7·8% (542/6910), hazard ratio (HR) 0·46, 95% CI 0·40–0·53; hip fractures 0·8% (65/8043) versus 1·6% (125/8028), 0·53, 0·39–0·71; non-vertebral fractures 5·1% (412/8043) versus 6·7% (541/8028), 0·77, 0·68–0·87; all p
       
  • Skeletal considerations in the medical treatment of transgender people
    • Abstract: Publication date: Available online 31 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Sundeep Khosla, Caroline Davidge-Pitts
       
  • Correction to Lancet Diabetes Endocrinol 2019; 7: 845–54
    • Abstract: Publication date: Available online 25 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s):
       
  • Diabetes: a metabolic and reproductive disorder in women
    • Abstract: Publication date: Available online 18 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Eleanor P Thong, Ethel Codner, Joop S E Laven, Helena TeedeSummaryReproductive dysfunction is a common but little studied complication of diabetes. The spectrum of reproductive health problems in diabetes is broad, and encompasses delayed puberty and menarche, menstrual cycle abnormalities, subfertility, adverse pregnancy outcomes, and potentially early menopause. Depending on the age at diagnosis of diabetes, reproductive problems can manifest early on in puberty, emerge later when fertility is desired, or occur during the climacteric period. Historically, women with type 1 diabetes have frequently had amenorrhoea and infertility, due to central hypogonadism. With the intensification of insulin therapy and improved metabolic control, these problems have declined, but do persist. Additional reproductive implications of contemporary diabetes management are now emerging, including polycystic ovary syndrome and hyperandrogenism, which are underpinned by insulin action on the ovary. The sharp rise in type 2 diabetes incidence in youth suggests that more women of reproductive age will encounter diabetes-related reproductive problems in their lifetimes. With an ever increasing number of young women living with diabetes, clinicians need to be aware of and equipped for the challenges of navigating reproductive health concerns across the lifespan.
       
  • Diabetes clusters and risk of diabetes-associated diseases
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Shufang Liu, Wenquan Niu
       
  • Research digest: new horizons in heart failure therapy
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Naveed Sattar, David Preiss
       
  • 55th Annual Meeting of the European Association for the Study of Diabetes
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Neil Bennet
       
  • Correction to Lancet Diabetes Endocrinol 2019; 7: 855–65
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s):
       
  • Correction to Lancet Diabetes Endocrinol 2019; 7: 356–67
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s):
       
  • Maternal pre-pregnancy obesity and preterm birth: more explorations needed
           – Authors' reply
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Buyun Liu, Wei Bao
       
  • Maternal pre-pregnancy obesity and preterm birth: more explorations needed
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Yuan Yuan, Wenquan Niu
       
  • Diabetes clusters and risk of diabetes-associated diseases –
           Authors' reply
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Oana P Zaharia, Oliver Kuss, Klaus Strassburger, Volker Burkart, Julia Szendroedi, Michael Roden
       
  • Menopausal hormone therapy: is there cause for concern'
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s): Susan R Davis
       
  • Let's talk about sex
    • Abstract: Publication date: November 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 11Author(s):
       
  • Diabetic peripheral neuropathy: advances in diagnosis and strategies for
           screening and early intervention
    • Abstract: Publication date: Available online 14 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Dinesh Selvarajah, Debasish Kar, Kamlesh Khunti, Melanie J Davies, Adrian R Scott, Jeremy Walker, Solomon TesfayeSummaryDiabetic peripheral neuropathy (DPN) is a common complication of both type 1 and 2 diabetes. It is a leading cause of lower-limb amputation and disabling neuropathic pain. Amputations in patients with diabetes have a devastating effect on quality of life and are associated with an alarmingly low life expectancy (on average only 2 years from the amputation). Amputation also places a substantial financial burden on health-care systems and society in general. With the introduction of national diabetes eye screening programmes, the prevalence of blindness in working-age adults is falling. This is not the case, however, with diabetes related amputations. In this Review, we appraise innovative point-of-care devices that enable the early diagnosis of DPN and assess the evidence for early risk factor-based management strategies to reduce the incidence and slow the progression of DPN. We also propose a framework for screening and early multifactorial interventions as the best prospect for preventing or halting DPN and its devastating sequelae.
       
  • Opioid-induced endocrinopathies
    • Abstract: Publication date: Available online 14 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Athanasios Fountas, Stan Van Uum, Niki KaravitakiSummaryThe use of opioids is becoming a global epidemic, leading to a rise in the occurrence and recognition of the effects of opioid drugs on the endocrine system. Nonetheless, opioid-induced endocrinopathies still remain underdiagnosed, mainly because of symptom under-reporting by patients and poor clinician awareness. Hypogonadism is the most well recognised consequence of opioid use, but the inhibitory effects of opioid drugs on the hypothalamo–pituitary–adrenal axis and their negative effects on bone health also require attention. Hyperprolactinaemia might be detected in opioid users, but clinically relevant thyroid dysfunction has not been identified. The effects of opioids on other hormones have not been clearly defined. Assessment of gonadal and adrenal function (particularly if high index of clinical suspicion of hypogonadism or hypoadrenalism) and evaluation of bone health are advised in people that use opiods. Discontinuation or reduction of opioid dose and appropriate hormone replacement are the management approaches that should be considered for hypogonadism and hypoadrenalism. Further research is needed to facilitate the development of evidence-based guidelines on the diagnosis and optimal management of opioid-induced endocrinopathies.
       
  • Cushing's disease—from Minnie G to key issues in the early 21st
           century
    • Abstract: Publication date: Available online 7 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Alan Kelsall, John Newell-PriceSummaryOct 7, 2019, marks the 80th anniversary of the death of Harvey Cushing, the father of modern neurosurgery. Here we give a historical perspective from Cushing's original description of the clinical syndrome that now bears his name through to the modern day. We highlight some of the key milestones that allowed improved understanding and management of this extraordinarily challenging condition, and identify some of the key issues that still exist in the 21st century.
       
  • Screening for differentiated thyroid cancer in selected populations
    • Abstract: Publication date: Available online 4 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Livia Lamartina, Giorgio Grani, Cosimo Durante, Sebastiano Filetti, David S CooperSummaryThe main purpose of cancer screening programmes should not be to detect all cancers, but to discover potentially fatal or clinically relevant cancers. The US Preventive Services Task Force recommends against screening for thyroid cancer in the general, asymptomatic adult population, as such screening would result in harms that outweigh any potential benefits. This recommendation does not apply to patients with symptoms or to individuals at increased risk of thyroid cancer because of a history of exposure to ionising radiation (in childhood, as radioactive fallout, or in medical treatment as low-dose radiotherapy for benign conditions or high-dose radiation for malignancy), inherited genetic syndromes associated with thyroid cancer (eg, familial adenomatous polyposis), or one or more first-degree relatives with a history of thyroid cancer. We discuss the evidence for and against screening individuals who are at high risk, and consider the different screening tools available.
       
  • SGLT2 inhibitors as adjunctive therapy for type 1 diabetes: balancing
           benefits and risks
    • Abstract: Publication date: Available online 1 October 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Simeon I Taylor, Jenny E Blau, Kristina I Rother, Amber L BeitelsheesSummarySodium-glucose co-transporter-2 (SGLT2) inhibitors have several beneficial effects in patients with type 2 diabetes, including glucose lowering, weight loss, blood pressure lowering, and a reduced risk of major adverse cardiovascular events. To address high unmet medical need via improved glycaemic control, several clinical trials have been done to assess the efficacy and safety of SGLT2 inhibitors in combination with insulin therapy in patients with type 1 diabetes. In this Personal View, we summarise data from eight clinical trials of canagliflozin, dapagliflozin, empagliflozin, and sotagliflozin in patients with type 1 diabetes. HbA1c-lowering efficacy was greatest at 8–12 weeks of therapy, but the magnitude of HbA1c lowering waned with longer duration of treatment (up to 52 weeks). Data are not yet available to establish for how long glycaemic efficacy could be sustained during long-term therapy in patients with type 1 diabetes. Moreover, SGLT2 inhibitor therapy induces serious adverse events, including a roughly six-times increased risk of diabetic ketoacidosis. The US Food and Drug Administration estimated that one additional case of ketoacidosis will occur for every 26 patient-years of exposure of patients with type 1 diabetes to sotagliflozin therapy. Assuming a case mortality of 0·4%, this estimate translates into 16 additional deaths per year per 100 000 patients with type 1 diabetes undergoing treatment. These considerations raise important questions about the risk-to-benefit profile of SGLT2 inhibitors when used as adjunctive therapy in patients with type 1 diabetes.
       
  • Rare dyslipidaemias, from phenotype to genotype to management: a European
           Atherosclerosis Society task force consensus statement
    • Abstract: Publication date: Available online 30 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Robert A Hegele, Jan Borén, Henry N Ginsberg, Marcello Arca, Maurizio Averna, Christoph J Binder, Laura Calabresi, M John Chapman, Marina Cuchel, Arnold von Eckardstein, Ruth Frikke-Schmidt, Daniel Gaudet, G Kees Hovingh, Florian Kronenberg, Dieter Lütjohann, Klaus G Parhofer, Frederick J Raal, Kausik K Ray, Alan T Remaley, Jane K StockSummaryGenome sequencing and gene-based therapies appear poised to advance the management of rare lipoprotein disorders and associated dyslipidaemias. However, in practice, underdiagnosis and undertreatment of these disorders are common, in large part due to interindividual variability in the genetic causes and phenotypic presentation of these conditions. To address these challenges, the European Atherosclerosis Society formed a task force to provide practical clinical guidance focusing on patients with extreme concentrations (either low or high) of plasma low-density lipoprotein cholesterol, triglycerides, or high-density lipoprotein cholesterol. The task force also recognises the scarcity of quality information regarding the prevalence and outcomes of these conditions. Collaborative registries are needed to improve health policy for the care of patients with rare dyslipidaemias.
       
  • The sinister side of Cushing's therapy
    • Abstract: Publication date: Available online 18 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Ashley Grossman
       
  • High sugar content in baby food: an Indian perspective
    • Abstract: Publication date: October 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 10Author(s): Shampa Ghosh, Manchala Raghunath, Bhudev Chandra Das, Jitendra Kumar Sinha
       
  • Unaffordable insulin: patients pay the price
    • Abstract: Publication date: October 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 10Author(s): Fiona Conner, Elizabeth Pfiester, James Elliott, Anbreen Slama-Chaudhry
       
  • SGLT2 inhibitor or GLP-1 receptor agonist in type 2 diabetes'
    • Abstract: Publication date: Available online 17 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): André J Scheen
       
  • Empowering women with PCOS
    • Abstract: Publication date: Available online 6 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): The Lancet Diabetes & Endocrinology
       
  • Tackling metabolic risk: opportunities and challenges
    • Abstract: Publication date: Available online 6 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): The Lancet Diabetes & Endocrinology
       
  • SGLT2 inhibitors for the prevention of kidney failure in patients with
           type 2 diabetes: a systematic review and meta-analysis
    • Abstract: Publication date: Available online 5 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Brendon L Neuen, Tamara Young, Hiddo J L Heerspink, Bruce Neal, Vlado Perkovic, Laurent Billot, Kenneth W Mahaffey, David M Charytan, David C Wheeler, Clare Arnott, Severine Bompoint, Adeera Levin, Meg J JardineSummaryBackgroundThe effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on kidney failure, particularly the need for dialysis or transplantation or death due to kidney disease, is uncertain. Additionally, previous studies have been underpowered to robustly assess heterogeneity of effects on kidney outcomes by different levels of estimated glomerular filtration rate (eGFR) and albuminuria. We aimed to do a systematic review and meta-analysis to assess the effects of SGLT2 inhibitors on major kidney outcomes in patients with type 2 diabetes and to determine the consistency of effect size across trials and different levels of eGFR and albuminuria.MethodsWe did a systematic review and meta-analysis of randomised, controlled, cardiovascular or kidney outcome trials of SGLT2 inhibitors that reported effects on major kidney outcomes in people with type 2 diabetes. We searched MEDLINE and Embase from database inception to June 14, 2019, to identify eligible trials. The primary outcome was a composite of dialysis, transplantation, or death due to kidney disease. We used random-effects models to obtain summary relative risks (RRs) with 95% CIs and random-effects meta-regression to explore effect modification by subgroups of baseline eGFR, albuminuria, and use of renin–angiotensin system (RAS) blockade. This review is registered with PROSPERO (CRD42019131774).FindingsFrom 2085 records identified, four studies met our inclusion criteria, assessing three SGLT2 inhibitors: empagliflozin (EMPA-REG OUTCOME), canagliflozin (CANVAS Program and CREDENCE), and dapagliflozin (DECLARE–TIMI 58). From a total of 38 723 participants, 252 required dialysis or transplantation or died of kidney disease, 335 developed end-stage kidney disease, and 943 had acute kidney injury. SGLT2 inhibitors substantially reduced the risk of dialysis, transplantation, or death due to kidney disease (RR 0·67, 95% CI 0·52–0·86, p=0·0019), an effect consistent across studies (I2=0%, pheterogeneity=0·53). SGLT2 inhibitors also reduced end-stage kidney disease (0·65, 0·53–0·81, p
       
  • Diabetic kidney disease 2.0: the treatment paradigm shifts
    • Abstract: Publication date: Available online 5 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Richard E Gilbert
       
  • NICE guidance on dapagliflozin with insulin for type 1 diabetes
    • Abstract: Publication date: Available online 2 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Amanda I Adler, Sharlene Ting, Ross Dent, Nick Latimer
       
  • Personalising osteoporosis treatment for patients at high risk of fracture
    • Abstract: Publication date: Available online 22 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Sundeep Khosla
       
  • Practical definitions of severe versus familial hypercholesterolaemia and
           hypertriglyceridaemia for adult clinical practice
    • Abstract: Publication date: Available online 21 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Ankit Garg, Vinay Garg, Robert A Hegele, Gary F LewisSummaryDiagnostic scoring systems for familial hypercholesterolaemia and familial chylomicronaemia syndrome often cannot differentiate between adults who have extreme dyslipidaemia based on a simple monogenic cause versus people with a more complex cause involving polygenic factors and an environmental component. This more complex group of patients carries a substantial risk of atherosclerotic cardiovascular disease in the case of marked hypercholesterolaemia and pancreatitis in the case of marked hypertriglyceridaemia. Complications are mainly a function of the degree of disturbance in lipid metabolism resulting in elevated lipid levels, so the added value of knowing the precise genetic cause in clinical decision making is unclear and does not lead to clinically meaningful benefit. We propose that for severe elevations of plasma low density lipoprotein cholesterol or triglyceride, the primary factor driving intervention should be the biochemical perturbation rather than the clinical risk score. This underscores the importance of expanding the definition of severe dyslipidaemias and to not rely solely on clinical scoring systems to identify individuals who would benefit from appropriate treatment approaches. We advocate for the use of simple, practical, clinical, and largely biochemically based definitions for severe hypercholesterolaemia (eg, LDL cholesterol>5 mmol/L) and severe hypertriglyceridaemia (triglyceride>10 mmol/L), which complement current definitions of familial hypercholesterolaemia and familial chylomicronaemia syndrome. Irrespective of the precise genetic cause, individuals diagnosed with severe hypercholesterolaemia and severe hypertriglyceridaemia require intensive therapy, including special consideration for new effective but more expensive therapies.
       
  • The CGM grey market: a reflection of global access inequity
    • Abstract: Publication date: Available online 16 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Oana Onisie, Hamish Crocket, Martin de Bock
       
  • Metabolic health in the Middle East and north Africa
    • Abstract: Publication date: Available online 14 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Fereidoun Azizi, Farzad Hadaegh, Farhad Hosseinpanah, Parvin Mirmiran, Atieh Amouzegar, Hengameh Abdi, Golaleh Asghari, Donna Parizadeh, Seyed Ali Montazeri, Mojtaba Lotfaliany, Farzin Takyar, Davood KhaliliSummaryThe Middle East and north Africa are home to different populations with widely varying cultures, histories, and socioeconomic settings. Hence, their health status, health management, and access to appropriate health care differ accordingly. In this Review, we examine data on the historical and prospective status of metabolic diseases in this region including obesity, diabetes, hypertension, dyslipidaemia, and non-alcoholic fatty liver disease. Women in the Middle East and north Africa have the highest risk of metabolic diseases of all women globally, whereas men rank second of all men in this respect. Metabolic risk factors are responsible for more than 300 deaths per 100 000 individuals in this region, compared with a global mean of fewer than 250. Physical inactivity, especially in women, and an unhealthy diet (ie, low consumption of whole grains, nuts, and seafoods) stand out. More than one in every three women are obese in most countries of the region. Prevention programmes have not fully been achieved in most of these countries and the projected future is not optimistic. Comprehensive surveillance and monitoring of metabolic diseases, robust multisectoral systems that support primordial and primary preventions, continuous education of health-care providers, as well as collaboration between countries for joint projects in this region are urgently needed to overcome the paucity of data and to improve the metabolic health status of inhabitants in the Middle East and north Africa.
       
  • GLP-1 receptor agonists and cardiovascular outcomes: an updated synthesis
    • Abstract: Publication date: Available online 14 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Eberhard Standl
       
  • Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor
           agonists in patients with type 2 diabetes: a systematic review and
           meta-analysis of cardiovascular outcome trials
    • Abstract: Publication date: Available online 14 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Søren L Kristensen, Rasmus Rørth, Pardeep S Jhund, Kieran F Docherty, Naveed Sattar, David Preiss, Lars Køber, Mark C Petrie, John J V McMurraySummaryBackgroundGlucagon-like peptide-1 (GLP-1) receptor agonists differ in their structure and duration of action and have been studied in trials of varying sizes and with different patient populations, with inconsistent effects on cardiovascular outcomes reported. We aimed to synthesise the available evidence by doing a systematic review and meta-analysis of cardiovascular outcome trials of these drugs.MethodsWe searched MEDLINE (via PubMed) and the Cochrane Central Register of Controlled Trials for eligible placebo-controlled trials reporting major adverse cardiovascular events (MACE; ie, cardiovascular death, stroke, or myocardial infarction) up to June 15, 2019. We did a meta-analysis using a random-effects model to estimate overall hazard ratios (HRs) for MACE, its components, death from any cause, hospital admission for heart failure, kidney outcomes, and key safety outcomes (severe hypoglycaemia, pancreatitis, and pancreatic cancer). We also examined MACE in several subgroups based on patient characteristics (history of cardiovascular disease, BMI, age, baseline HbA1c, and baseline estimated glomerular filtration rate), trial duration, treatment dosing interval, and structural homology.FindingsOf 27 publications screened, seven trials, with a combined total of 56 004 participants, were included: ELIXA (lixisenatide), LEADER (liraglutide), SUSTAIN-6 (semaglutide), EXSCEL (exenatide), Harmony Outcomes (albiglutide), REWIND (dulaglutide), and PIONEER 6 (oral semaglutide). Overall, GLP-1 receptor agonist treatment reduced MACE by 12% (HR 0·88, 95% CI 0·82–0·94; p
       
  • Treading one's own path
    • Abstract: Publication date: Available online 8 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Fiona Mitchell
       
  • A paradigm shift in bariatric surgery outcome evaluation'
    • Abstract: Publication date: Available online 2 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Xabier Unamuno, Piero Portincasa, Gema Frühbeck
       
  • Long-term adverse events after sleeve gastrectomy or gastric bypass: a
           7-year nationwide, observational, population-based, cohort study
    • Abstract: Publication date: Available online 2 August 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Jérémie Thereaux, Thomas Lesuffleur, Sébastien Czernichow, Arnaud Basdevant, Simon Msika, David Nocca, Bertrand Millat, Anne Fagot-CampagnaSummaryBackgroundConcerns are rising about the late adverse events following gastric bypass and sleeve gastrectomy. We aimed to assess, over a 7-year period, the late adverse events after gastric bypass and sleeve gastrectomy compared with matched control groups.MethodsIn this nationwide, observational, population-based, cohort study, we used data extracted from the French National Health Insurance (Système National des Données de Santé) database. All patients undergoing gastric bypass or sleeve gastrectomy in France in 2009, except those who had undergone bariatric surgery in the previous 4 years before inclusion, were matched with control patients with obesity in terms of age, sex, BMI category, baseline antidiabetic therapy, and baseline insulin therapy. Exclusion criteria for the control group included cancer, pregnancy, chronic infectious disease, serious acute or chronic disease in 2008–09, or previous (2005–09) or forthcoming (2010–11) bariatric surgery. The incidence rate was calculated for each type of adverse event leading to inpatient hospital admission over a 7-year period; incidence rate ratios (with 95% CIs) were computed to compare the rate of complications among the bariatric surgery and control groups. Risks of complications during follow-up were compared using Cox proportional-hazards regression analyses. Data were analysed according to the intention-to-treat methodology.FindingsFrom Jan 1, 2009, to Dec 31, 2009, 8966 patients who underwent bariatric surgery (7359 [82%] women; mean age 40·4 years [SD 11·3]) and 8966 matched controls (7359 [82%] women; mean age 40·9 years [11·4]) were included in analyses 4955 (55%) off 8966 patients in the bariatric surgery group had a primary gastric bypass and 4011 (45%) patients had sleeve gastrectomy. With a mean follow-up of 6·8 years (SD 0·2), mortality was lower in the gastric bypass group than in its control group (hazard ratio 0·64 [95% CI 0·52–0·78]; p
       
  • Testosterone for women: green light for sex, amber light for health'
    • Abstract: Publication date: Available online 25 July 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Rossella E Nappi
       
  • The role of blood volume in cardiac dysfunction and reduced exercise
           tolerance in patients with diabetes
    • Abstract: Publication date: Available online 26 June 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): David Montero, Candela Diaz-Canestro, Laura Oberholzer, Carsten LundbySummaryBlood volume is an integral component of the cardiovascular system, and fundamental to discerning the pathophysiology of multiple cardiovascular conditions leading to exercise intolerance. Based on a systematic search of controlled studies assessing blood volume, in this Personal View we describe how hypovolaemia is a prevalent characteristic of patients with diabetes, irrespective of sex, age, and physical activity levels. Multiple endocrine and haematological mechanisms contribute to hypovolaemia in diabetes. The regulation of intravascular volumes is altered by sustained hyperglycaemia and hypertension. Chronic activation of endocrine systems controlling fluid homeostasis, such as the renin–angiotensin–aldosterone system and vasopressin axis, has a role in progressive kidney desensitisation and diabetic nephropathy. Furthermore, albumin loss from the intravascular compartment reduces the osmotic potential of plasma to retain water. Hypovolaemia also affects the loading conditions and filling of the heart in diabetes. The elucidation of modifiable volumetric traits will plausibly have major health benefits in the diabetes population.
       
  • Amos Laar: combating non-communicable diseases in Ghana
    • Abstract: Publication date: Available online 12 June 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Ray Cavanaugh
       
  • Three generational phenotypes of sporadic primary hyperparathyroidism:
           evolution defined by technology
    • Abstract: Publication date: Available online 3 June 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Cristiana Cipriani, John P Bilezikian
       
  • Diabetes in pregnancy and epigenetic mechanisms—how the first 9 months
           from conception might affect the child's epigenome and later risk of
           disease
    • Abstract: Publication date: Available online 22 May 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Line Hjort, Boris Novakovic, Louise G Grunnet, Louise Maple-Brown, Peter Damm, Gernot Desoye, Richard SafferySummaryDiabetes in pregnancy is not only associated with increased risk of pregnancy complications and subsequent maternal metabolic disease, but also increases the risk of long-term metabolic disease in the offspring. At the interface between genetic and environmental factors, epigenetic variation established in utero represents a plausible link between the in utero environment and later disease susceptibility. The identification of an epigenetic fingerprint of diabetes in pregnancy linked to the metabolic health of the offspring might provide novel biomarkers for the identification of offspring most at risk, before the onset of metabolic dysfunction, for targeted monitoring and intervention. In this Personal View, we (1) highlight the scale of the problem of diabetes in pregnancy, (2) summarise evidence for the variation in offspring epigenetic profiles following exposure to diabetes in utero, and (3) outline potential future approaches to further understand the mechanisms by which exposure to maternal metabolic dysfunction in pregnancy is transmitted through generations.
       
  • Sicker, Fatter, Poorer: The Urgent Threat of Hormone-Disrupting Chemicals
           to Our Health and Future…and What We Can Do About It, Leonardo Trasande.
           Houghton Mifflin Harcourt (2019), 240, US$22·00, ISBN: 978-1328553492
    • Abstract: Publication date: Available online 16 May 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Michele A La Merrill
       
  • Sugar and Tension: Diabetes and Gender in Modern India, Lesley Jo Weaver.
           Rutgers University Press (2018), 202, US$34·95, ISBN: 978-1-9788-0300-8
    • Abstract: Publication date: Available online 10 May 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Latha Palaniappan
       
  • The Elephant in the Room: One Fat Man's Quest to Get Smaller in a Growing
           America, Tommy Tomlinson. Simon & Schuster (2019), 256, £16·99, ISBN:
           978-1501111617
    • Abstract: Publication date: Available online 24 April 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Stuart W Flint
       
 
 
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