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The Lancet Diabetes and Endocrinology
Journal Prestige (SJR): 9.705
Citation Impact (citeScore): 6
Number of Followers: 141  
 
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ISSN (Online) 2213-8587
Published by Elsevier Homepage  [3162 journals]
  • Incidence and progression of diabetic retinopathy: a systematic review
    • Abstract: Publication date: Available online 11 July 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Charumathi Sabanayagam, Riswana Banu, Miao Li Chee, Ryan Lee, Ya Xing Wang, Gavin Tan, Jost B Jonas, Ecosse L Lamoureux, Ching-Yu Cheng, Barbara E K Klein, Paul Mitchell, Ronald Klein, C M Gemmy Cheung, Tien Y WongSummaryDiabetic retinopathy is a leading cause of vision impairment and blindness. We systematically reviewed studies published from Jan 1, 1980, to Jan 7, 2018, assessed the methodological quality, and described variations in incidence of diabetic retinopathy by region with a focus on population-based studies that were conducted after 2000 (n=8, including two unpublished studies). Of these eight studies, five were from Asia, and one each from the North America, Caribbean, and sub-Saharan Africa. The annual incidence of diabetic retinopathy ranged from 2·2% to 12·7% and progression from 3·4% to 12·3%. Progression to proliferative diabetic retinopathy was higher in individuals with mild disease compared with those with no disease at baseline. Our Review suggests that more high-quality population-based studies capturing data on the incidence and progression of diabetic retinopathy with stratification by age and sex are needed to consolidate the evidence base. Our data is useful for conceptualisation and development of major public health strategies such as screening programmes for diabetic retinopathy.
       
  • A genetic approach to evaluation of short stature of undetermined cause
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Philip G Murray, Peter E Clayton, Steven D ChernausekSummaryShort stature is a common presentation to paediatric endocrinologists. After exclusion of major endocrine or systemic disease, most children with short stature are diagnosed based on a description of their growth pattern and the height of their parents (eg, familial short stature). Height is a polygenic trait and genome-wide association studies have identified many of the associated genetic loci. Here we review the application of genetic studies, including copy number variant analysis, targeted gene panels, and whole-exome sequencing in children with idiopathic short stature. We estimate 25–40% of children diagnosed with idiopathic short stature could receive a molecular diagnosis using these technologies. A molecular diagnosis for short stature is important for affected individuals and their families and might inform treatment decisions surrounding use of growth hormone or insulin-like growth factor 1 therapy.
       
  • Effect of neprilysin inhibition on renal function in patients with type 2
           diabetes and chronic heart failure who are receiving target doses of
           inhibitors of the renin-angiotensin system: a secondary analysis of the
           PARADIGM-HF trial
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Milton Packer, Brian Claggett, Martin P Lefkowitz, John J V McMurray, Jean L Rouleau, Scott D Solomon, Michael R ZileSummaryBackgroundNeprilysin inhibition has favourable effects on experimental diabetic nephropathy. We sought to assess the effects of neprilysin inhibition on the course of renal function in patients with type 2 diabetes.MethodsIn the randomised, double-blind PARADIGM-HF trial, the effects of sacubitril/valsartan (97 mg/103 mg twice daily) were compared with enalapril (10 mg twice daily) in 8399 patients with mild-to-moderate chronic heart failure and systolic dysfunction. In this secondary intention-to-treat analysis, we assessed the change in estimated glomerular filtration rate (eGFR) over a 44-month follow-up period in patients with (n=3784) and those without (n=4615) diabetes. PARADIGM-HF is registered with ClinicalTrials.gov, number NCT01035255.FindingseGFR decreased by 1·1 mL/min per 1·73 m2 per year (95% CI 1·0–1·2) in patients without diabetes, but by 2·0 mL/min per 1·73 m2 per year (1·9–2·1) in those with diabetes (p
       
  • Sex-specific relevance of diabetes to occlusive vascular and other
           mortality: a collaborative meta-analysis of individual data from 980 793
           adults from 68 prospective studies
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): L Gnatiuc, WG Herrington, J Halsey, J Tuomilehto, X Fang, HC Kim, D De Bacquer, AJ Dobson, MH Criqui, DR Jacobs, DA Leon, SAE Peters, H Ueshima, P Sherliker, R Peto, R Collins, RR Huxley, JR Emberson, M Woodward, S LewingtonSummaryBackgroundSeveral studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men.MethodsIn our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes.ResultsIndividual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97–2·24) and tripled risk among women (3·00, 2·71–3·33; χ2 test for heterogeneity p
       
  • Islet transplantation versus insulin therapy in patients with type 1
           diabetes with severe hypoglycaemia or poorly controlled glycaemia after
           kidney transplantation (TRIMECO): a multicentre, randomised controlled
           trial
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Sandrine Lablanche, Marie-Christine Vantyghem, Laurence Kessler, Anne Wojtusciszyn, Sophie Borot, Charles Thivolet, Sophie Girerd, Domenico Bosco, Jean-Luc Bosson, Cyrille Colin, Rachel Tetaz, Sophie Logerot, Julie Kerr-Conte, Eric Renard, Alfred Penfornis, Emmanuel Morelon, Fanny Buron, Kristina Skaare, Gwen Grguric, Coralie Camillo-BraultSummaryBackgroundIslet transplantation is indicated for patients with type 1 diabetes with severe hypoglycaemia or after kidney transplantation. We did a randomised trial to assess the efficacy and safety of islet transplantation compared with insulin therapy in these patients.MethodsIn this multicentre, open-label, randomised controlled trial, we randomly assigned (1:1) patients with type 1 diabetes at 15 university hospitals to receive immediate islet transplantation or intensive insulin therapy (followed by delayed islet transplantation). Eligible patients were aged 18–65 years and had severe hypoglycaemia or hypoglycaemia unawareness, or kidney grafts with poor glycaemic control. We used computer-generated randomisation, stratified by centre and type of patient. Islet recipients were scheduled to receive 11 000 islet equivalents per kg bodyweight in one to three infusions. The primary outcome was proportion of patients with a modified β-score (in which an overall score of 0 was not allocated when stimulated C-peptide was negative) of 6 or higher at 6 months after first islet infusion in the immediate transplantation group or 6 months after randomisation in the insulin group. The primary analysis included all patients who received the allocated intervention; safety was assessed in all patients who received islet infusions. This trial is registered with ClinicalTrials.gov, number NCT01148680, and is completed.FindingsBetween July 8, 2010, and July 29, 2013, 50 patients were randomly assigned to immediate islet transplantation (n=26) or insulin treatment (n=24), of whom three (one in the immediate islet transplantation group and two in the insulin therapy group) did not receive the allocated intervention. Median follow-up was 184 days (IQR 181–186) in the immediate transplantation group and 185 days (172–201) in the insulin therapy group. At 6 months, 16 (64% [95% CI 43–82]) of 25 patients in the immediate islet transplantation group had a modified β-score of 6 or higher versus none (0% [0–15]) of the 22 patients in the insulin group (p
       
  • Correction to Lancet Diabetes Endocrinol 2018; 6: 517–19
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s):
       
  • Research in brief
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Seema Kang
       
  • Improving the clinical impact of randomised trials in thyroidology
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Tim I M Korevaar, Layal Chaker, Robin P Peeters
       
  • Target blood pressure and kidney protection
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Giuseppe Mancia
       
  • Renal effects of sacubitril/valsartan in patients with diabetes
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Stefan Störk
       
  • Diabetes and cardiovascular mortality: the impact of sex
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Anna Norhammar
       
  • Islet transplantation in type 1 diabetes: moving forward
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): Shareen Forbes, Peter A Senior, A M James Shapiro
       
  • Food nutritional information: transparency and public health
    • Abstract: Publication date: July 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 7Author(s): The Lancet Diabetes & Endocrinology
       
  • The truth in beige and white
    • Abstract: Publication date: Available online 22 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Talha Khan Burki
       
  • Renal outcomes in CVOTs: keep calm and carry on
    • Abstract: Publication date: Available online 21 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Marcel H A Muskiet, Michaël J B van Baar, Rosalie A Scholtes, Daniël H van Raalte
       
  • Dulaglutide and renal protection in type 2 diabetes
    • Abstract: Publication date: Available online 14 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): David Z I Cherney, Subodh Verma, John D Parker
       
  • TV advertising and childhood obesity in the UK
    • Abstract: Publication date: Available online 7 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Talha Khan Burki
       
  • Work stress and risk of death in men and women with and without
           cardiometabolic disease: a multicohort study
    • Abstract: Publication date: Available online 5 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Mika Kivimäki, Jaana Pentti, Jane E Ferrie, G David Batty, Solja T Nyberg, Markus Jokela, Marianna Virtanen, Lars Alfredsson, Nico Dragano, Eleonor I Fransson, Marcel Goldberg, Anders Knutsson, Markku Koskenvuo, Aki Koskinen, Anne Kouvonen, Ritva Luukkonen, Tuula Oksanen, Reiner Rugulies, Johannes Siegrist, Archana Singh-ManouxSummaryBackgroundAlthough some cardiovascular disease prevention guidelines suggest a need to manage work stress in patients with established cardiometabolic disease, the evidence base for this recommendation is weak. We sought to clarify the status of stress as a risk factor in cardiometabolic disease by investigating the associations between work stress and mortality in men and women with and without pre-existing cardiometabolic disease.MethodsIn this multicohort study, we used data from seven cohort studies in the IPD-Work consortium, initiated between 1985 and 2002 in Finland, France, Sweden, and the UK, to examine the association between work stress and mortality. Work stress was denoted as job strain or effort–reward imbalance at work. We extracted individual-level data on prevalent cardiometabolic diseases (coronary heart disease, stroke, or diabetes [without differentiation by diabetes type]) at baseline. Work stressors, socioeconomic status, and conventional and lifestyle risk factors (systolic and diastolic blood pressure, total cholesterol, smoking status, BMI, physical activity, and alcohol consumption) were also assessed at baseline. Mortality data, including date and cause of death, were obtained from national death registries. We used Cox proportional hazards regression to study the associations of work stressors with mortality in men and women with and without cardiometabolic disease.ResultsWe identified 102 633 individuals with 1 423 753 person-years at risk (mean follow-up 13·9 years [SD 3·9]), of whom 3441 had prevalent cardiometabolic disease at baseline and 3841 died during follow-up. In men with cardiometabolic disease, age-standardised mortality rates were substantially higher in people with job strain (149·8 per 10 000 person-years) than in those without (97·7 per 10 000 person-years; mortality difference 52·1 per 10 000 person-years; multivariable-adjusted hazard ratio [HR] 1·68, 95% CI 1·19–2·35). This mortality difference for job strain was almost as great as that for current smoking versus former smoking (78·1 per 10 000 person-years) and greater than those due to hypertension, high total cholesterol concentration, obesity, physical inactivity, and high alcohol consumption relative to the corresponding lower risk groups (mortality difference 5·9–44·0 per 10 000 person-years). Excess mortality associated with job strain was also noted in men with cardiometabolic disease who had achieved treatment targets, including groups with a healthy lifestyle (HR 2·01, 95% CI 1·18–3·43) and those with normal blood pressure and no dyslipidaemia (6·17, 1·74–21·9). In all women and in men without cardiometabolic disease, relative risk estimates for the work stress–mortality association were not significant, apart from effort–reward imbalance in men without cardiometabolic disease (mortality difference 6·6 per 10 000 person-years; multivariable-adjusted HR 1·22, 1·06–1·41).InterpretationIn men with cardiometabolic disease, the contribution of job strain to risk of death was clinically significant and independent of conventional risk factors and their treatment, and measured lifestyle factors. Standard care targeting conventional risk factors is therefore unlikely to mitigate the mortality risk associated with job strain in this population.FundingNordForsk, UK Medical Research Council, and Academy of Finland.
       
  • Stress at work in patients with cardiometabolic disease
    • Abstract: Publication date: Available online 5 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Yulong Lian
       
  • The earlier the better: preconception vitamin D and protection against
           pregnancy loss
    • Abstract: Publication date: Available online 5 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Martin Hewison
       
  • Precision medicine in KCNJ11 permanent neonatal diabetes
    • Abstract: Publication date: Available online 4 June 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Siri Atma W Greeley, Lisa R Letourneau, Louis H Philipson
       
  • Tomorrow Will Be Different: Love, Loss, and the Fight for Trans Equality,
           Sarah McBride. Crown Archetype (2018), 288, £19·99, ISBN: 978-1524761479
           
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Robert Stirrups
       
  • Research digest: assessment and risks of obesity
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Naveed Sattar, David Preiss
       
  • Novel diabetes subgroups – Authors' reply
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Emma Ahlqvist, Rashmi B Prasad, Tiinamaija Tuomi, Anders Rosengren, Leif Groop
       
  • Novel diabetes subgroups
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Maarten van Smeden, Frank E Harrell, Darren L Dahly
       
  • Novel diabetes subgroups
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Michael D Feher, Neil Munro, David Russell-Jones, Simon de Lusignan, Kamlesh Khunti
       
  • Novel diabetes subgroups
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Sylwia Dziegielewska-Gesiak, Dorota Stoltny, Malgorzata Muc-Wierzgon
       
  • Novel diabetes subgroups
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Deep Dutta, Satinath Mukhopadhyay
       
  • Retraction and republication—Worldwide burden of cancer attributable to
           diabetes and high body-mass index: a comparative risk assessment
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): The Editors of The Lancet Diabetes & Endocrinology
       
  • SGLT2 inhibitors: hypotheses on the mechanism of cardiovascular protection
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Robert M Bell, Derek M Yellon
       
  • Glycaemic control and glycaemic variability in older people with diabetes
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Hermes J Florez
       
  • Fluid retention, aldosterone excess, and treatment of resistant
           hypertension
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): David A Calhoun
       
  • Diabetes duration, HbA1c, and cause-specific mortality in
           Mexico
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Armando Arredondo
       
  • Denosumab: a new treatment option for glucocorticoid-induced osteoporosis
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Elena Tsourdi, Lorenz C Hofbauer
       
  • Transgender health: access to care under threat
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): The Lancet Diabetes & Endocrinology
       
  • Follicular thyroid cancer and Hürthle cell carcinoma: challenges in
           diagnosis, treatment, and clinical management
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Giorgio Grani, Livia Lamartina, Cosimo Durante, Sebastiano Filetti, David S CooperSummaryFollicular thyroid cancer is the second most common differentiated thyroid cancer histological type and has been overshadowed by its more common counterpart—papillary thyroid cancer—despite its unique biological behaviour and less favourable outcomes. In this Review, we comprehensively review the literature on follicular thyroid cancer to provide an evidence-based guide to the management of these tumours, to highlight the lack of evidence behind guideline recommendations, and to identify changes and challenges over the past decades in diagnosis, prognosis, and treatment. We highlight that correct identification of cancer in indeterminate cytological samples is challenging and ultrasonographic features can be misleading. Despite certain unique aspects of follicular thyroid cancer presentation and prognosis, no specific recommendations exist for follicular thyroid cancer and Hürthle cell carcinoma in evidence-based guidelines. Efforts should be made to stimulate additional research in this field.
       
  • Optimisation of follow-up after metabolic surgery
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Geltrude Mingrone, Stefan Bornstein, Carel W Le RouxSummaryBariatric surgery has many benefits beyond weight loss, including improved control of glycaemia, blood pressure, and dyslipidaemia; hence, such surgery has been rebranded as metabolic surgery. The operations are, unfortunately, also associated with major surgical and medical complications. The medical complications include gastro-oesophageal reflux disease, malnutrition, and metabolic complications deriving from vitamin and mineral malabsorption. The benefits of surgery can be optimised by implementing specific protocols before and after surgery. In this Review, we discuss the assessment of the risk of major cardiac complications and severe obstructive sleep apnoea before surgery, and the provision of adequate lifelong postsurgery nutritional, vitamin, and mineral supplementation to reduce complications. Additionally, we examine the best antidiabetic medications to reduce the risk of hypoglycaemia after gastric bypass and sleeve gastrectomy, and the strategies to improve weight loss or reduce weight regain. Although optimising clinical pathways is possible to maximise metabolic benefits and reduce the risks of complications and micronutrient deficiencies, evolution of these strategies can further improve the risk-to-benefit ratio of metabolic surgery.
       
  • Worldwide burden of cancer attributable to diabetes and high body-mass
           index: a comparative risk assessment
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Jonathan Pearson-Stuttard, Bin Zhou, Vasilis Kontis, James Bentham, Marc J Gunter, Majid EzzatiSummaryBackgroundDiabetes and high body-mass index (BMI) are associated with increased risk of several cancers, and are increasing in prevalence in most countries. We estimated the cancer incidence attributable to diabetes and high BMI as individual risk factors and in combination, by country and sex.MethodsWe estimated population attributable fractions for 12 cancers by age and sex for 175 countries in 2012. We defined high BMI as a BMI greater than or equal to 25 kg/m2. We used comprehensive prevalence estimates of diabetes and BMI categories in 2002, assuming a 10-year lag between exposure to diabetes or high BMI and incidence of cancer, combined with relative risks from published estimates, to quantify contribution of diabetes and high BMI to site-specific cancers, individually and combined as independent risk factors and in a conservative scenario in which we assumed full overlap of risk of diabetes and high BMI. We then used GLOBOCAN cancer incidence data to estimate the number of cancer cases attributable to the two risk factors. We also estimated the number of cancer cases in 2012 that were attributable to increases in the prevalence of diabetes and high BMI from 1980 to 2002. All analyses were done at individual country level and grouped by region for reporting.FindingsWe estimated that 5·7% of all incident cancers in 2012 were attributable to the combined effects of diabetes and high BMI as independent risk factors, corresponding to 804 100 new cases. 187 600 (24·5%) of 766 000 cases of liver cancer and 121 700 (38·4%) of 317 000 cases of endometrial cancer were attributable to these risk factors. In the conservative scenario, about 4·5% (629 000 new cases) of all incident cancers assessed were attributable to diabetes and high BMI combined. Individually, high BMI (544 300 cases) was responsible for almost twice as many cancer cases as diabetes (293 300 cases). 25·8% of diabetes-related cancers (equating to 75 600 new cases) and 31·9% of high BMI-related cancers (174 040 new cases) were attributable to increases in the prevalence of these risk factors from 1980 to 2002.InterpretationA substantial number of cancer cases are attributable to diabetes and high BMI. As the prevalence of these cancer risk factors increases, clinical and public health efforts should focus on identifying optimal preventive and screening measures for whole populations and individual patients.FundingNIHR and Wellcome Trust.
       
  • Mean HbA1c, HbA1c variability, and mortality in people with diabetes aged
           70 years and older: a retrospective cohort study
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Angus Forbes, Trevor Murrells, Henrietta Mulnier, Alan J SinclairSummaryBackgroundGlycaemic targets for older people have been revised in recent years because of concern that more stringent targets are associated with increased mortality. We aimed to investigate the association between glycaemic control (mean HbA1c) and variability (variability of HbA1c over time) and mortality in older people with diabetes.MethodsWe did a 5-year retrospective cohort study using The Health Improvement Network database, which includes data from 587 UK primary care practices. We included patients of either sex who were aged 70 years and older with type 1 or type 2 diabetes. The primary outcome was time to all-cause mortality. Our primary exposure variables were mean HbA1c and variability of HbA1c over time. The observation included a 4-year run-in period (from 2003) as a baseline, with a 5-year follow-up (from 2007 to 2012). We assessed mean HbA1c in three models: a baseline mean HbA1c for 2003–06 (model 1), the mean across the whole follow-up period (model 2), and a time-varying yearly updated mean (model 3). A variability score (from 0 [low] to 100 [high]) was calculated on the basis of number of changes in HbA1c of 0·5% (5·5 mmol/mol) or more from 2003 to 2012 or to the point of mortality, based on changes in the annual mean as per each model with a minimum of six readings.FindingsThe cohort consisted of 54 803 people, of whom 17 680 (8614 [30·7%] of 28 017 women and 9066 [33·8%] of 26 786 men) died during the observation period. The overall mortality rate was 77 per 1000 person-years (73 per 1000 person-years for women and 80 per 1000 person-years for men). The data showed a J-shaped distribution for mortality risk in both sexes, with significant increases with HbA1c values greater than 8% (64 mmol/mol) and less than 6% (42 mmol/mol), although excess mortality risk was non-significant in model 1 for men at HbA1c values of 8% (64 mmol/mol) to less than 8·5% (
       
  • Endocrine and haemodynamic changes in resistant hypertension, and blood
           pressure responses to spironolactone or amiloride: the PATHWAY-2
           mechanisms substudies
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Bryan Williams, Thomas M MacDonald, Steve V Morant, David J Webb, Peter Sever, Gordon T McInnes, Ian Ford, J Kennedy Cruickshank, Mark J Caulfield, Sandosh Padmanabhan, Isla S Mackenzie, Jackie Salsbury, Morris J Brown, The British Hypertension Society programme of Prevention And Treatment of Hypertension With Algorithm based Therapy (PATHWAY) Study GroupSummaryBackgroundIn the PATHWAY-2 study of resistant hypertension, spironolactone reduced blood pressure substantially more than conventional antihypertensive drugs. We did three substudies to assess the mechanisms underlying this superiority and the pathogenesis of resistant hypertension.MethodsPATHWAY-2 was a randomised, double-blind crossover trial done at 14 UK primary and secondary care sites in 314 patients with resistant hypertension. Patients were given 12 weeks of once daily treatment with each of placebo, spironolactone 25–50 mg, bisoprolol 5–10 mg, and doxazosin 4–8 mg and the change in home systolic blood pressure was assessed as the primary outcome. In our three substudies, we assessed plasma aldosterone, renin, and aldosterone-to-renin ratio (ARR) as predictors of home systolic blood pressure, and estimated prevalence of primary aldosteronism (substudy 1); assessed the effects of each drug in terms of thoracic fluid index, cardiac index, stroke index, and systemic vascular resistance at seven sites with haemodynamic monitoring facilities (substudy 2); and assessed the effect of amiloride 10–20 mg once daily on clinic systolic blood pressure during an optional 6–12 week open-label runout phase (substudy 3). The PATHWAY-2 trial is registered with EudraCT, number 2008–007149–30, and ClinicalTrials.gov, number NCT02369081.FindingsOf the 314 patients in PATHWAY-2, 269 participated in one or more of the three substudies: 126 in substudy 1, 226 in substudy 2, and 146 in substudy 3. Home systolic blood pressure reduction by spironolactone was predicted by ARR (r2=0·13, p
       
  • Correction to Lancet Diabetes Endocrinol 2018; 6: 274
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s):
       
  • Correction to Lancet Diabetes Endocrinol 2017; 5: 680–81
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s):
       
  • Correction to Lancet Diabetes Endocrinol 2018; 6: 370–81
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s):
       
  • Correction to Lancet Diabetes Endocrinol 2018; 6: 82–83
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s):
       
  • Changing the conversation
    • Abstract: Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Jules Morgan
       
  • Transition from metabolic healthy to unhealthy phenotypes and association
           with cardiovascular disease risk across BMI categories in 90 257 women
           (the Nurses' Health Study): 30 year follow-up from a prospective cohort
           study
    • Abstract: Publication date: Available online 31 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Nathalie Eckel, Yanping Li, Olga Kuxhaus, Norbert Stefan, Frank B Hu, Matthias B SchulzeSummaryBackgroundCardiovascular disease risk among individuals across different categories of BMI might depend on their metabolic health. It remains unclear to what extent metabolic health status changes over time and whether this affects cardiovascular disease risk. In this study, we aimed to examine the association between metabolic health and its change over time and cardiovascular disease risk across BMI categories.MethodsBetween June and December, 1976, 121 701 female nurses were recruited to the Nurses' Health Study (NHS) of whom 103 298 returned a questionnaire in 1980 used as baseline in this study. After excluding women with a history of cardiovascular disease or cancer, with missing body weight and with underweight. 90 257 women were followed-up from 1980 to 2010 for incident cardiovascular disease. Participants were cross-classified by BMI categories, metabolic health (defined by absence of diabetes, hypertension and hypercholesterolaemia), and change in metabolic health status during follow-up. The cardiovascular component of the NHS is registered with ClinicalTrials.gov, number NCT00005152.FindingsDuring 2 127  391 person-years of follow-up with a median follow-up of 24 years, we documented 6306 cases of cardiovascular disease including 3304 myocardial infarction cases and 3080 strokes. Cardiovascular disease risk of women with metabolically healthy obesity was increased compared with women with metabolically healthy normal weight (HR 1·39, 95% CI 1·15–1·68), but risk was considerably higher in women with metabolically unhealthy normal weight (2·43, 2·19–2·68), overweight (2·61, 2·36–2·89) and obesity (3·15, 2·83–3·50). The majority of metabolically healthy women converted to unhealthy phenotypes (2555 [84%] of 3027 women with obesity, 22 215 [68%] of 32 882 women with normal-weight after 20 years). Women who maintained metabolically healthy obesity during follow-up were still at a higher cardiovascular disease risk compared with women with stable healthy normal weight (HR 1·57, 1·03–2·38), yet this risk was lower than for initially metabolically healthy women who converted to an unhealthy phenotype (normal-weight 1·90, 1·66–2·17 vs obesity 2·74, 2·30–3·27). Particularly incident diabetes and hypertension increased the risk among women with initial metabolic health.InterpretationEven when metabolic health is maintained during long periods of time, obesity remains a risk factor for cardiovascular disease. However, risks are highest for metabolically unhealthy women across all BMI categories. A large proportion of metabolically healthy women converted to an unhealthy phenotype over time across all BMI categories, which is associated with an increased cardiovascular disease risk.FundingUS National Institutes of Health, German Federal Ministry of Education and Research.
       
  • Obesity is rarely healthy
    • Abstract: Publication date: Available online 31 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Carl J Lavie, Prakash Deedwania, Francisco B Ortega
       
  • Association of preconception serum 25-hydroxyvitamin D concentrations with
           livebirth and pregnancy loss: a prospective cohort study
    • Abstract: Publication date: Available online 31 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Sunni L Mumford, Rebecca A Garbose, Keewan Kim, Kerri Kissell, Daniel L Kuhr, Ukpebo R Omosigho, Neil J Perkins, Noya Galai, Robert M Silver, Lindsey A Sjaarda, Torie C Plowden, Enrique F SchistermanSummaryBackgroundVitamin D deficiency during pregnancy is associated with adverse pregnancy outcomes, although the association between preconception vitamin D concentrations and livebirth is unknown. We aimed to assess the association between preconception vitamin D and pregnancy outcomes among women with proven fecundity.MethodsWe did a secondary analysis of a prospective cohort from the block-randomised, double-blind, placebo-controlled EAGeR trial. Women aged 18–40 years with one to two previous pregnancy losses were recruited from June 15, 2007, to July 15, 2011, at four clinical sites in the USA and followed up for up to six menstrual cycles while attempting pregnancy and throughout pregnancy if they conceived. Serum 25-hydroxyvitamin D was measured at baseline (preconception) and 8 weeks of gestation. Outcomes of interest included clinical pregnancy, time to pregnancy, pregnancy loss, and livebirths. Risk ratios (RRs) and 95% CIs for livebirths, pregnancy, and pregnancy loss were estimated with weighted log-binomial regression. To assess time to pregnancy, we used discrete time Cox proportional hazards models to calculate fecundability odds ratios (FORs) with 95% CIs. EAGeR is registered with ClinicalTrials.gov, number NCT00467363.Findings1191 women had available data on preconception 25-hydroxyvitamin D concentrations. 555 (47%) women were classified as having sufficient concentrations (≥75 nmol/L) and 636 (53%) as having insufficient concentrations (
       
  • Outcome after ablation in patients with low-risk thyroid cancer
           (ESTIMABL1): 5-year follow-up results of a randomised, phase 3,
           equivalence trial
    • Abstract: Publication date: Available online 26 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Martin Schlumberger, Sophie Leboulleux, Bogdan Catargi, Desiree Deandreis, Slimane Zerdoud, Stephane Bardet, Daniela Rusu, Yann Godbert, Camille Buffet, Claire Schvartz, Pierre Vera, Olivier Morel, Danielle Benisvy, Claire Bournaud, Marie-Elisabeth Toubert, Antony Kelly, Ellen Benhamou, Isabelle BorgetSummaryBackgroundIn ESTIMABL1, a randomised phase 3 trial of radioactive iodine (131I) administration after complete surgical resection in patients with low-risk thyroid cancer, 92% of patients had complete thyroid ablation at 6–10 months, defined as a recombinant human thyroid-stimulating hormone (rhTSH)-stimulated serum thyroglobulin concentration of 1 ng/mL or less and normal findings on neck ultrasonography. Equivalence was shown between low-activity (1·1 GBq) and high-activity (3·7 GBq) radioactive iodine and also between the use of rhTSH injections and thyroid hormone withdrawal. Here, we report outcomes after 5 years of follow-up.MethodsThis multicentre, randomised, open-label, equivalence trial was done at 24 centres in France. Between March 28, 2007, and Feb 25, 2010, we randomly assigned (1:1:1:1) adults with low-risk differentiated thyroid carcinoma who had undergone total thyroidectomy to one of four strategies, each combining one of two methods of thyrotropin stimulation (rhTSH or thyroid hormone withdrawal) and one of two radioactive iodine activities (1·1 GBq or 3·7 GBq). Randomisation was by computer-generated sequence, with variable block size. Follow-up consisted of a yearly serum thyroglobulin measurement on levothyroxine treatment. Measurement of rhTSH-stimulated thyroglobulin and neck ultrasonography were done at the discretion of the treating physician. No evidence of disease was defined as serum thyroglobulin of 1 ng/mL or less on levothyroxine treatment and normal results on neck ultrasonography, when performed. This study was registered with ClinicalTrials.gov, number NCT00435851.Findings726 patients (97% of the 752 patients originally randomised) were followed up. At a median follow-up since randomisation of 5·4 years (range 0·5–9·2), 715 (98%) had no evidence of disease. The other 11 had either structural disease (n=4), raised serum thyroglobulin concentration (n=5), or indeterminate findings on neck ultrasonography (n=2). At ablation, six of these patients had received 1·1 GBq radioactive iodine (five after rhTSH and one after withdrawal) and five had received 3·7 GBq (two after rhTSH and three after withdrawal). TSH-stimulated (either after rhTSH injections or thyroid hormone withdrawal according to the treatment group) thyroglobulin concentration measured at the time of ablation was prognostic for structural disease status at ablation, ablation status at 6–10 months, and the final outcome.InterpretationOur findings suggest that disease recurrence was not related to the strategy used for ablation. These data validate the use of 1·1 GBq radioactive iodine after rhTSH for postoperative ablation in patients with low-risk thyroid cancer.FundingFrench National Cancer Institute (INCa), French Ministry of Health, and Sanofi Genzyme.
       
  • Preferred strategy for postsurgical thyroid ablation in low-risk thyroid
           cancer
    • Abstract: Publication date: Available online 26 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Furio Pacini
       
  • Psoriasis: a novel risk factor for type 2 diabetes
    • Abstract: Publication date: Available online 21 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Joel M Gelfand, Marilyn T Wan
       
  • Correction to Lancet Diabetes Endocrinol 2018; published online May 4.
           http://dx.doi.org/10.1016/S2213-8587(18)30105-0
    • Abstract: Publication date: Available online 10 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s):
       
  • New hope for glucokinase activators in type 2 diabetes'
    • Abstract: Publication date: Available online 4 May 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): André J Scheen
       
  • Precision medicine in the management of type 2 diabetes
    • Abstract: Publication date: Available online 23 April 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Anna L Gloyn, Daniel J DruckerSummaryThe study of type 2 diabetes has been driven by advances in human genetics, epigenetics, biomarkers, mechanistic studies, and large clinical trials, enabling new insights into disease susceptibility, pathophysiology, progression, and development of complications. Simultaneously, several new drug classes with different mechanisms of action have been introduced over the past two decades, accompanied by data about cardiovascular safety and non-glycaemic outcomes. In this Review, we critically examine the progress and integration of this new science into clinical practice, and review opportunities for enabling the use of precision medicine in the diagnosis and treatment of type 2 diabetes. We contrast the success in delivering personalised medicine for monogenic diabetes with the greater challenge of providing a precision medicine approach for type 2 diabetes, highlighting gaps, limitations, and areas requiring further study.
       
  • Correction to Lancet Diabetes Endocrinol 2018; published online on Feb 20.
           http://dx.doi.org/10.1016/S2213-8587(18)30035-4
    • Abstract: Publication date: Available online 10 April 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s):
       
  • Bone health during endocrine therapy for cancer
    • Abstract: Publication date: Available online 20 March 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Tilman D Rachner, Robert Coleman, Peyman Hadji, Lorenz C HofbauerSummaryPreservation of bone health remains a long-term clinical challenge in patients with breast and prostate cancer. Osteoporosis, defined by a loss of bone mass and microarchitecture, often results in fragility fractures that are typically associated with a high socioeconomic burden. Endocrine therapy, a mainstay treatment in the management of patients with hormone-sensitive breast and prostate cancer in the adjuvant setting, commonly exerts adverse effects on the musculoskeletal system and is associated with an increased risk of osteoporosis and fractures. Adjuvant use of gonadotropin-releasing hormone analogues, which can also be used in metastatic disease, in combination with tamoxifen in premenopausal women, and aromatase inhibitors in postmenopausal women with hormone-sensitive breast cancer, causes rapid bone loss and fragility fractures. By contrast, selective oestrogen receptor modulators, such as tamoxifen, have bone-protective effects in postmenopausal women. In men with castration-sensitive prostate cancer, androgen deprivation is achieved with drugs that lower gonadotropin levels, and these drugs can be combined with androgen receptor antagonists. These therapies induce a high bone turnover with rapid bone loss that is reminiscent of the changes occurring in early menopause and result in an increased risk of fracture. In this Review, we describe how adjuvant endocrine therapies of breast and prostate cancer impair bone health and outline evidence from randomised controlled trials of strategies to reduce risk of fracture.
       
  • Do sulphonylureas still have a place in clinical practice'
    • Abstract: Publication date: Available online 28 February 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Kamlesh Khunti, Sudesna Chatterjee, Hertzel C Gerstein, Sophia Zoungas, Melanie J DaviesSummarySulphonylureas have been commercially available since the 1950s, but their use continues to be associated with controversy. Although adverse cardiovascular outcomes in some observational studies have raised concerns about sulphonylureas, findings from relatively recent, robust, and high-quality systematic reviews have indicated no increased risk of all-cause mortality associated with sulphonylureas compared with other active treatments. Results from large, multicentre, randomised controlled trials such as the UK Prospective Diabetes Study and ADVANCE have confirmed the microvascular benefits of sulphonylureas, a reduction in the incidence or worsening of nephropathy and retinopathy, and no increase in all-cause mortality, although whether these benefits were due to sulphonylurea therapy and not an overall glucose-lowering effect could not be confirmed. A comparison of sulphonylureas and pioglitazone in the TOSCA.IT trial also confirmed the efficacy and cardiovascular safety of sulphonylureas. Investigators of randomised controlled trials have reported an increased risk of hypoglycaemia and weight gain with sulphonylureas, but data from observational studies suggest that the incidence of severe hypoglycaemia is lower in people taking sulphonylurea than in people taking insulin, and weight gain with sulphonylureas has been relatively modest in large cohort studies. 80% of people with diabetes live in low-to-middle income countries, so the effectiveness, affordability, and safety of sulphonylureas are particularly important considerations when prescribing glucose-lowering therapy. Results of ongoing head-to-head studies with new drugs, such as the comparison of glimepiride with linagliptin in the CAROLINA study and the comparison of various therapies (including sulphonylureas) for glycaemic control in the GRADE study, will determine the place of sulphonylureas in glucose-lowering therapy algorithms for patients with type 2 diabetes.
       
  • Macrovascular disease and risk factors in youth with type 1 diabetes: time
           to be more attentive to treatment'
    • Abstract: Publication date: Available online 20 February 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Petter Bjornstad, Kim C Donaghue, David M MaahsSummaryCardiovascular disease remains the leading cause of mortality in patients with type 1 diabetes. Although cardiovascular disease complications are rare until adulthood, pathology and early markers can manifest in adolescence. Whereas advances have been made in the management of microvascular complications of type 1 diabetes, similar progress in reducing macrovascular complications has not been made. The reasons for the absence of progress remain incompletely understood, but most likely relate to the long time needed for cardiovascular disease to manifest clinically and hence for risk factor management to show a clinical benefit, thus allowing inertia to prevail for diagnosis and particularly for targeting risk factors. In this Review, we summarise paediatric data on traditional and novel risk factors of cardiovascular disease, provide an overview of data from previous and current clinical trials, discuss future directions in cardiovascular disease research for paediatric patients with type 1 diabetes, and advocate for the early identification and treatment of cardiovascular disease risk factors as recommended in multiple guidelines.
       
  • Sickle-cell trait and diagnosis of type 2 diabetes
    • Abstract: Publication date: Available online 17 February 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Sarah Skinner, Vincent Pialoux, Bérengère Fromy, Dominique Sigaudo-Roussel, Philippe Connes
       
  • Personalised blood pressure ranges in type 2 diabetes'
    • Abstract: Publication date: Available online 29 January 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Martin K Rutter, Naveed Sattar
       
  • Keeping it off: the challenge of weight-loss maintenance
    • Abstract: Publication date: Available online 19 January 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Michael Lean, Catherine Hankey
       
 
 
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