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The Lancet Diabetes and Endocrinology
Journal Prestige (SJR): 9.705
Citation Impact (citeScore): 6
Number of Followers: 202  
 
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ISSN (Online) 2213-8587
Published by Elsevier Homepage  [3161 journals]
  • Estimands in diabetes clinical trials
    • Abstract: Publication date: Available online 21 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Thinzar Min, Stephen C Bain
       
  • Alcohol and illicit drug use in people with diabetes
    • Abstract: Publication date: Available online 17 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Adam Pastor, Jennifer Conn, Richard J MacIsaac, Yvonne BonomoSummaryAs the prevalence of type 1 and type 2 diabetes increases and population-level patterns of alcohol and illicit drug use evolve, clinicians will continue to encounter people with diabetes whose substance use is affecting health outcomes. Substance use contributes substantially to the population-level prevalence of cardiovascular events, cerebrovascular events, cancers, mental health conditions, road trauma, and domestic violence. Alcohol and drug use also have a measurable effect on diabetes incidence and the development of both acute and chronic diabetes-related complications. In this Review, we examine the effect of alcohol and illicit drug use on people with type 1 or type 2 diabetes. We describe evidence for substance use as a risk factor for new-onset diabetes, prevalence of use in people with diabetes, evidence linking substance use with diabetes-related health outcomes, and evidence on the management of these co-occurring conditions.
       
  • Tackling obesity in 2020—with a great resolution comes shared
           responsibility
    • Abstract: Publication date: Available online 9 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): The Lancet Diabetes & Endocrinology
       
  • Smoking cessation, weight gain, and cardiovascular risk
    • Abstract: Publication date: Available online 7 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Katarina Kos
       
  • REWIND to fast forward: time to revisit stroke prevention in type 2
           diabetes'
    • Abstract: Publication date: Available online 7 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Vanita Aroda
       
  • The effect of dulaglutide on stroke: an exploratory analysis of the REWIND
           trial
    • Abstract: Publication date: Available online 7 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Hertzel C Gerstein, Robert Hart, Helen M Colhoun, Rafael Diaz, Mark Lakshmanan, Fady T Botros, Jeffrey Probstfield, Matthew C Riddle, Lars Rydén, Charles Messan Atisso, Leanne Dyal, Stephanie Hall, Alvaro Avezum, Jan Basile, Ignacio Conget, William C Cushman, Nicolae Hancu, Markolf Hanefeld, Petr Jansky, Matyas KeltaiSummaryBackgroundCardiovascular outcome trials have suggested that glucagon-like peptide 1 (GLP-1) receptor agonists might reduce strokes. We analysed the effect of dulaglutide on stroke within the researching cardiovascular events with a weekly incretin in diabetes (REWIND) trial.MethodsREWIND was a multicentre, randomised, double-blind, placebo-controlled trial done at 371 sites in 24 countries. Men and women (aged ≥50 years) with established or newly detected type 2 diabetes whose HbA1c was 9·5% or less (with no lower limit) on stable doses of up to two oral glucose-lowering drugs with or without basal insulin therapy were eligible if their body-mass index was at least 23 kg/m2. Participants were randomly assigned (1:1) to weekly subcutaneous injections of either masked dulaglutide 1·5 mg or the same volume of masked placebo (containing the same excipients but without dulaglutide). Randomisation was done by a computer-generated random code with an interactive web response system with stratification by site. Participants, investigators, the trial leadership, and all other personnel were masked to treatment allocation until the trial was completed and the database was locked. During the treatment period, participants in both groups were instructed to inject study drug on the same day at around the same time, each week. Strokes were categorised as fatal or non-fatal, and as either ischaemic, haemorrhagic, or undetermined. Stroke severity was assessed using the modified Rankin scale. Participants were seen at 2 weeks, 3 months, 6 months, and then every 3 months for drug dispensing and every 6 months for detailed assessments, until 1200 confirmed primary outcomes accrued. The primary endpoint was the first occurrence of any component of the composite outcome, which comprised non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular or unknown causes. All analyses were done according to an intention-to-treat strategy that included all randomly assigned participants, irrespective of adherence. The trial is registered with ClinicalTrials.gov, number NCT01394952.FindingsBetween Aug 18, 2011, and Aug 14, 2013, we screened 12 133 patients, of whom 9901 with type 2 diabetes and additional cardiovascular risk factors were randomly assigned to either dulaglutide (n=4949) or an equal volume of placebo (n=4952). During a median follow-up of 5·4 years, cerebrovascular and other cardiovascular outcomes were ascertained and adjudicated. 158 (3·2%) of 4949 participants assigned to dulaglutide and 205 (4·1%) of 4952 participants assigned to placebo had a stroke during follow-up (hazard ratio [HR] 0·76, 95% CI 0·62–0·94; p=0·010). Dulaglutide reduced ischaemic stroke (0·75, 0·59–0·94, p=0·012) but had no effect on haemorrhagic stroke (1·05, 0·55–1·99; p=0·89). Dulaglutide also reduced the composite of non-fatal stroke or all-cause death (0·88, 0·79–0·98; p=0·017) and disabling stroke (0·74, 0·56–0·99; p=0·042). The degree of disability after stroke did not differ by treatment group.InterpretationLong-term dulaglutide use might reduce clinically relevant ischaemic stroke in people with type 2 diabetes but does not affect stroke severity.FundingEli Lilly and Company.
       
  • Approach to patients with hypophosphataemia
    • Abstract: Publication date: Available online 7 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Pablo Florenzano, Cristiana Cipriani, Kelly L Roszko, Seiji Fukumoto, Michael T Collins, Salvatore Minisola, Jessica PepeSummaryPhosphate metabolism is an evolving area of basic and clinical research. In the past 15 years, knowledge on disturbances of phosphate homoeostasis has expanded, as has the discovery of new targeted therapies. Hypophosphataemia might be the biochemical finding in several diseases, and its clinical evaluation should initially focus on the assessment of pathophysiological mechanisms leading to low serum phosphate concentrations. Clinical consequences of hypophosphataemia can involve multiple organ systems and vary depending on several factors, the most important being the underlying disorder. This Review focuses on the approach to patients with hypophosphataemia and how underlying pathophysiological mechanisms should be understood in the evaluation of differential diagnosis. We define an algorithm for the assessment of hypophosphataemia and review the most up-to-date literature on specific therapies. Continuous research in this area will result in a better understanding and management of patients with hypophosphataemia.
       
  • Smoking cessation and weight change in relation to cardiovascular disease
           incidence and mortality in people with type 2 diabetes: a population-based
           cohort study
    • Abstract: Publication date: Available online 7 January 2020Source: The Lancet Diabetes & EndocrinologyAuthor(s): Gang Liu, Yang Hu, Geng Zong, An Pan, JoAnn E Manson, Kathryn M Rexrode, Eric B Rimm, Frank B Hu, Qi SunSummaryBackgroundTo reduce their overall substantially increased risk of cardiovascular disease and premature mortality, smoking cessation is especially important for people with diabetes. However, the effect of weight change after quitting smoking on the long-term health consequences of smoking cessation is unclear. We aimed to examine smoking cessation and subsequent weight change in relation to incident cardiovascular disease events and mortality among adults with type 2 diabetes.MethodsIn this population-based cohort study, we analysed data from people with type 2 diabetes from two prospective cohorts in the USA: the Nurses' Health Study (1976–2014) and the Health Professionals Follow-Up Study (1986–2014). We included participants from both cohorts who either had prevalent type 2 diabetes or were diagnosed during the study, and who were either current smokers or never smokers without cardiovascular disease or cancer at diagnosis of diabetes. Information on demographics, newly diagnosed diseases, medical history, and lifestyle factors, including smoking status and weight change, was updated every 2 years through validated questionnaires. We assessed the incidence of cardiovascular disease and all-cause and cause-specific mortality among recent quitters (within 6 years of stopping) and long-term quitters (>6 years) associated with weight change within 6 years of smoking cessation among people with type 2 diabetes. We did a multivariable-adjusted Cox proportional hazard models to estimate hazard ratios (HRs) for the associations of smoking cessation and weight change on the outcomes.FindingsOf 173 229 total cohort participants (121 700 from the Nurses' Health Study and 51 529 from the Health Professionals Follow-Up Study), 10 809 people with type 2 diabetes were included in the incident cardiovascular disease analysis and 9688 were included in the mortality analysis. 2580 incident cases of cardiovascular disease occurred during 153 166 person-years of follow-up, and 3827 deaths occurred during 152 811 person-years of follow-up. Recent quitters (2–6 consecutive years since smoking cessation) without weight gain within the first 6 years of quitting had a significantly lower risk of cardiovascular disease than people who continued to smoke (multivariable-adjusted HR 0·83 [95% CI 0·70–0·99] among all recent quitters, 0·77 [0·62–0·95] among recent quitters without weight gain, 0·99 [0·70–1·41] among recent quitters with weight gain of 0·1–5·0 kg, 0·89 [0·65–1·23] among recent quitters with weight gain of>5·0 kg, and 0·72 [0·61–0·84] among longer-term quitters [>6 consecutive years since smoking cessation]). Weight gain within 6 years after smoking cessation did not attenuate the inverse relation between long-term cessation and all-cause mortality (multivariable-adjusted HR 0·69 [95% CI 0·58–0·82] among long-term quitters without weight gain, 0·57 [0·45–0·71] among long-term quitters with weight gain of 0·1–5·0 kg, and 0·51 [0·42–0·62] among long-term quitters with weight gain of>5·0 kg), with similar results observed for cardiovascular disease and cancer mortality.InterpretationSmoking cessation without subsequent weight gain is associated with a reduced risk of cardiovascular disease and mortality among smokers with type 2 diabetes. Weight gain after smoking cessation attenuates the reduction in risk of developing cardiovascular disease, but does not attenuate the beneficial effect of smoking cessation with respect to mortality. These findings confirm the overall health benefits of quitting smoking among people with type 2 diabetes, but also emphasise the importance of weight management after smoking cessation to maximise its health benefits.FundingUS National Institutes of Health.
       
  • Intensive LDL cholesterol-lowering treatment beyond current
           recommendations for the prevention of major vascular events: a systematic
           review and meta-analysis of randomised trials including 327 037
           participants
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Nelson Wang, Jordan Fulcher, Nishan Abeysuriya, Laura Park, Shejil Kumar, Gian Luca Di Tanna, Ian Wilcox, Anthony Keech, Anthony Rodgers, Sean LalSummaryBackgroundThe benefits of LDL cholesterol-lowering treatment for the prevention of atherosclerotic cardiovascular disease are well established. However, the extent to which these effects differ by baseline LDL cholesterol, atherosclerotic cardiovascular disease risk, and the presence of comorbidities remains uncertain.MethodsWe did a systematic literature search (MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, from inception up to June 15, 2019) for randomised controlled trials of statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors with at least 1000 patient-years of follow-up. Random-effects meta-analysis and meta-regressions were done to assess for risk of major vascular events (a composite of cardiovascular mortality, non-fatal myocardial infarction, non-fatal ischaemic stroke, or coronary revascularisation) per 1 mmol/L (38·7 mg/dL) reduction in LDL cholesterol concentrations.Findings327 037 patients from 52 studies were included in the meta-analysis. Each 1 mmol/L reduction in LDL cholesterol was associated with a 19% relative risk (RR) reduction for major vascular events (RR 0·81 [95% CI 0·78–0·84]; p
       
  • Kidney outcomes associated with use of SGLT2 inhibitors in real-world
           clinical practice (CVD-REAL 3): a multinational observational cohort study
           
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Hiddo J L Heerspink, Avraham Karasik, Marcus Thuresson, Cheli Melzer-Cohen, Gabriel Chodick, Kamlesh Khunti, John P H Wilding, Luis Alberto Garcia Rodriguez, Lucia Cea-Soriano, Shun Kohsaka, Antonio Nicolucci, Giuseppe Lucisano, Fang-Ju Lin, Chih-Yuan Wang, Eric Wittbrodt, Peter Fenici, Mikhail KosiborodSummaryBackgroundCardiovascular and kidney outcome trials have shown that sodium-glucose co-transporter-2 (SGLT2) inhibitors slow progression of chronic kidney disease in patients with type 2 diabetes with or without chronic kidney disease. The aim of this study was to assess whether these benefits extend to patients with type 2 diabetes treated in routine clinical practice.MethodsCVD-REAL 3 was a multinational observational cohort study in which new users of SGLT2 inhibitors and other glucose-lowering drugs with measurements of estimated glomerular filtration rate (eGFR) before and after (within 180 days) initiation were identified via claims, medical records, and national registries in Israel, Italy, Japan, Taiwan, and the UK. Propensity scores for SGLT2 inhibitor initiation were developed in each country, with 1:1 matching with initiators of other glucose-lowering drugs. Propensity score included (in addition to other clinical and demographic variables) baseline eGFR and eGFR slope before SGLT2 inhibitor or other glucose-lowering drug initiation. The main outcome measure was rate of eGFR decline (slope) calculated with a linear mixed regression model. Differences in eGFR slope between SGLT2 inhibitors and other glucose-lowering drugs were calculated and pooled. We also assessed a composite outcome of 50% eGFR decline or end-stage kidney disease.FindingsAfter propensity matching, there were 35 561 episodes of treatment initiation in each group, from 65 231 individual patients. Dapagliflozin, empagliflozin, canagliflozin, ipragliflozin, tofogliflozin, and luseogliflozin accounted for 57·9%, 34·1%, 5·7%, 1·4%, 0·5%, and 0·4% of SGLT2 inhibitor initiation episodes, respectively. At baseline, 29 363 (41·3%) of 71 122 initiations were in women, mean age was 61·3 years, mean HbA1c was 72 mmol/mol (8·71%), and mean eGFR was 90·7 mL/min per 1·73 m2. During follow-up, SGLT2 inhibitor initiation was associated with reduced eGFR decline (difference in slope for SGLT2 inhibitors vs other glucose-lowering drugs 1·53 mL/min per 1·73 m2 per year, 95% CI 1·34–1·72, p
       
  • Exendin-based glucagon-like peptide-1 receptor agonists and anaphylactic
           reactions: a pharmacovigilance analysis
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Richeek Pradhan, François Montastruc, Vanessa Rousseau, Elisabetta Patorno, Laurent Azoulay
       
  • BPA: have flawed analytical techniques compromised risk assessments'
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Roy Gerona, Frederick S vom Saal, Patricia A Hunt
       
  • LDL cholesterol: lower, faster, younger'
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Amanda J Berberich, Robert A Hegele
       
  • SGLT2 inhibitors to prevent diabetic kidney disease
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Paola Fioretto, Roberto Vettor, Roberto Pontremoli
       
  • Professional mode flash glucose monitoring in type 2 diabetes
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): Norbert Hermanns, Dominic Ehrmann, Bernhard Kulzer
       
  • Action on improving access to insulin
    • Abstract: Publication date: January 2020Source: The Lancet Diabetes & Endocrinology, Volume 8, Issue 1Author(s): The Lancet Diabetes & Endocrinology
       
  • Insulin resistance versus β-cell dysfunction in type 2 diabetes: where
           public and personalised health meet
    • Abstract: Publication date: Available online 23 December 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Elaine Y K Chow, Juliana C N Chan
       
  • Association of insulin resistance and β-cell dysfunction with incident
           diabetes among adults in China: a nationwide, population-based,
           prospective cohort study
    • Abstract: Publication date: Available online 23 December 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Tiange Wang, Jieli Lu, Lixin Shi, Gang Chen, Min Xu, Yu Xu, Qing Su, Yiming Mu, Lulu Chen, Ruying Hu, Xulei Tang, Xuefeng Yu, Mian Li, Zhiyun Zhao, Yuhong Chen, Li Yan, Guijun Qin, Qin Wan, Meng Dai, Di ZhangSummaryBackgroundNational investigations on the interaction of insulin resistance, β-cell dysfunction, and obesity with the development of diabetes are scarce in China. We aimed to investigate the individual and joint associations of insulin resistance and β-cell dysfunction with incident diabetes, and to examine the modifying effect of BMI and waist circumference on these associations among adults with normal glucose tolerance and with prediabetes.MethodsIn this nationwide, population-based, prospective cohort study, we analysed data from the China Cardiometabolic Disease and Cancer Cohort Study, which recruited adults aged 40 years or older during 2011–12 (baseline) and invited participants to attend follow-up visits in 2014–16. Patients with diabetes at baseline, missing data for baseline measures of glucose tolerance status, missing data for baseline homoeostasis model assessment (HOMA) indexes, missing data for baseline covariates, and missing data for measures of glucose tolerance status at follow-up visits were excluded. At baseline and follow-up visits, a comprehensive set of questionnaires, clinical measurements, oral glucose tolerance tests, and laboratory examinations were carried out following standardised protocols. Glucose tolerance status and prediabetes were defined according to the American Diabetes Association 2010 criteria. In the main analysis, we examined the contributions of insulin resistance (HOMA of insulin resistance [HOMA-IR]) and β-cell dysfunction (HOMA of β-cell function [HOMA-B]) to diabetes risk, and evaluated the impact of obesity on these associations.Findings94 952 participants (31 517 men and 63 435 women) were included in the analysis. High HOMA-IR was associated with a greater hazard of diabetes (quartile 4 vs 1: hazard ratio [HR] 6·70, 95% CI 6·08–7·39; per unit increase in Z score: HR 2·17, 95% CI 2·10–2·24) than low HOMA-B (quartile 1 vs 4: 4·08, 3·72–4·48; per unit decrease in Z score: 1·92, 1·85–2·00). Approximately 24·4% (95% CI 23·6–25·2) of the incident diabetes could be attributed to insulin resistance and 12·4% (11·2–13·7) could be attributed to β-cell dysfunction. The HRs for diabetes were 1·83 (95% CI 1·72–1·95) per unit increase in Z score of HOMA-IR and 2·03 (1·86–2·21) per unit decrease in Z score of HOMA-B among participants with normal weight; the corresponding HRs for diabetes were 2·02 (1·93–2·11) and 1·88 (1·79–1·98) among participants with obesity (pinteraction=0·0091). These associations and interactions were similar for participants with normal glucose tolerance or prediabetes.InterpretationInsulin resistance shows a stronger association with incident diabetes than does β-cell dysfunction in Chinese adults, and this association pattern was more prominent among adults with obesity. Given the limitations of HOMA indexes as surrogate measures of insulin resistance and β-cell dysfunction, these findings should be interpreted with caution.FundingNational Natural Science Foundation of China.
       
  • The causal influence of maternal obesity on preterm birth
    • Abstract: Publication date: Available online 20 December 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Christoph F Kurz, Adriana N König
       
  • Choosing GLP-1 receptor agonists or SGLT-2 inhibitors by cardiorenal risk
    • Abstract: Publication date: Available online 13 December 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Clifford J Bailey
       
  • Helena Teede: driving collaboration and impact
    • Abstract: Publication date: Available online 12 December 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Tony Kirby
       
  • Iodine and folate—essential for mothers to be
    • Abstract: Publication date: Available online 27 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Malcolm Prentice, Janis Hickey, Mark Vanderpump, Peter N Taylor, John H Lazarus
       
  • Liberalisation, deintensification, and simplification in diabetes
           management: words matter
    • Abstract: Publication date: Available online 25 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Medha Munshi, Joshua J Neumiller
       
  • Physical activity and skeletal health in adults
    • Abstract: Publication date: Available online 20 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Jane A Cauley, Lora GiangregorioSummaryThe purpose of this Review is to examine the associations between physical activity and skeletal health, with an emphasis on observational studies with fracture outcomes and randomised controlled trials (RCTs) of physical activity interventions in adults older than 40 years. In general, increased physical activity—primarily leisure time activity or moderate or vigorous physical activity—is associated with a 1–40% lower risk of hip and all fractures. The primary limitation of these studies relates to health status; healthy people are more likely to exercise and less likely to fracture. Although there is no sufficiently powered RCT of exercise with a fracture outcome, there is evidence that some types of exercise prevent falls and bone loss, and meta-analyses support the anti-fracture effectiveness of exercise. RCTs and meta-analyses suggest that programmes combining impact exercise with moderate or high-intensity progressive resistance exercise might maintain or improve bone mass and prevent fractures, and that functional strength and balance training prevents falls.
       
  • ENDO 2020: a call for papers
    • Abstract: Publication date: December 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 12Author(s): Marta Koch, David Holmes, Neil Bennet
       
  • Long-term effects of intensive multifactorial therapy in individuals with
           screen-detected type 2 diabetes in primary care: 10-year follow-up of the
           ADDITION-Europe cluster-randomised trial
    • Abstract: Publication date: December 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 12Author(s): Simon J Griffin, Guy E H M Rutten, Kamlesh Khunti, Daniel R Witte, Torsten Lauritzen, Stephen J Sharp, Else-Marie Dalsgaard, Melanie J Davies, Greg J Irving, Rimke C Vos, David R Webb, Nicholas J Wareham, Annelli SandbækSummaryBackgroundThe multicentre, international ADDITION-Europe study investigated the effect of promoting intensive treatment of multiple risk factors among people with screen-detected type 2 diabetes over 5 years. Here we report the results of a post-hoc 10-year follow-up analysis of ADDITION-Europe to establish whether differences in treatment and cardiovascular risk factors have been maintained and to assess effects on cardiovascular outcomes.MethodsAs previously described, general practices from four centres (Denmark, Cambridge [UK], Leicester [UK], and the Netherlands) were randomly assigned by computer-generated list to provide screening followed by routine care of diabetes, or screening followed by intensive multifactorial treatment. Population-based stepwise screening programmes among people aged 40–69 years (50–69 years in the Netherlands), between April, 2001, and December, 2006, identified patients with type 2 diabetes. Allocation was concealed from patients. Following the 5-year follow-up, no attempts were made to maintain differences in treatment between study groups. In this report, we did a post-hoc analysis of cardiovascular and renal outcomes over 10 years following randomisation, including a 5 years post-intervention follow-up. As in the original trial, the primary endpoint was a composite of first cardiovascular event, including cardiovascular mortality, cardiovascular morbidity (non-fatal myocardial infarction and non-fatal stroke), revascularisation, and non-traumatic amputation, up to Dec 31, 2014. Analyses were based on the intention-to-treat principle. ADDITION-Europe is registered with ClinicalTrials.gov, NCT00237549.Findings343 general practices were randomly assigned to routine diabetes care (n=176) or intensive multifactorial treatment (n=167). 317 of these general practices (157 in the routine care group, 161 in the intensive treatment group) included eligible patients between April, 2001, and December, 2006. Of the 3233 individuals with screen-detected diabetes, 3057 agreed to participate (1379 in the routine care group, 1678 in the intensive treatment group), but at the 10-year follow-up 14 were lost to follow-up and 12 withdrew, leaving 3031 to enter 10-year follow-up analysis. Mean duration of follow-up was 9·61 years (SD 2·99). Sustained reductions over 10 years following diagnosis were apparent for bodyweight, HbA1c, blood pressure, and cholesterol in both study groups, but between-group differences identified at 1 and 5 years were attenuated at the 10-year follow-up. By 10 years, 443 participants had a first cardiovascular event and 465 died. There was no significant difference between groups in the incidence of the primary composite outcome (16·1 per 1000 person-years in the routine care group vs 14·3 per 1000 person-years in the intensive treatment group; hazard ratio [HR] 0·87, 95% CI 0·73–1·04; p=0·14) or all-cause mortality (15·6 vs 14·3 per 1000 person-years; HR 0·90, 0·76–1·07).InterpretationSustained reductions in glycaemia and related cardiovascular risk factors over 10 years among people with screen-detected diabetes managed in primary care are achievable. The differences in prescribed treatment and cardiovascular risk factors in the 5 years following diagnosis were not maintained at 10 years, and the difference in cardiovascular events and mortality remained non-significant.FundingNational Health Service Denmark, Danish Council for Strategic Research, Danish Research Foundation for General Practice, Novo Nordisk, Novo Nordisk Foundation, Danish Centre for Evaluation and Health Technology Assessment, Danish National Board of Health, Danish Medical Research Council, Aarhus University Research Foundation, Astra, Pfizer, GlaxoSmithKline, Servier, HemoCue, Wellcome Trust, UK Medical Research Council, UK National Institute for Health Research, UK National Health Service, Merck, Julius Center for Health Sciences and Primary Care, UK Department of Health, and Nuts-OHRA.
       
  • Correction to Lancet Diabetes Endocrinol 2019; 7: 959–64
    • Abstract: Publication date: December 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 12Author(s):
       
  • New article types now open for submissions and proposals
    • Abstract: Publication date: December 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 12Author(s): Marta Koch, David Holmes, Neil Bennet
       
  • ADDITION-Europe: the first decade and beyond
    • Abstract: Publication date: December 2019Source: The Lancet Diabetes & Endocrinology, Volume 7, Issue 12Author(s): Takayoshi Sasako, Takashi Kadowaki, Kohjiro Ueki
       
  • Reducing the treatment gap in osteoporosis
    • Abstract: Publication date: Available online 19 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Juliet Compston
       
  • Equitable diabetes care: still a long way off
    • Abstract: Publication date: Available online 14 November 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): The Lancet Diabetes & Endocrinology
       
  • 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
       
  • 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.
       
  • 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.
       
  • Amos Laar: combating non-communicable diseases in Ghana
    • Abstract: Publication date: Available online 12 June 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Ray Cavanaugh
       
  • 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
       
 
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