Showing papers in "The Lancet Diabetes & Endocrinology in 2018"

TL;DR: Five replicable clusters of patients with diabetes were identified, which had significantly different patient characteristics and risk of diabetic complications, which might eventually help to tailor and target early treatment to patients who would benefit most.

TL;DR: BMI was associated with all cause of death categories except for transport-related accidents, but the shape of the association varied, and the BMI associated with lowest mortality risk was higher in older individuals than in younger individuals.

TL;DR: The association between primary aldosteronism and adverse cardiac and cerebrovascular events, target organ damage, diabetes, and metabolic syndrome, compared with the association of essential hypertension was assessed.

TL;DR: Canagliflozin treatment was associated with a reduced risk of sustained loss of kidney function, attenuated eGFR decline, and a reduction in albuminuria in patients with type 2 diabetes.

TL;DR: Evidence is accumulating that young-onset type 2 diabetes has a more aggressive disease phenotype, leading to premature development of complications, with adverse effects on quality of life and unfavourable effects on long-term outcomes, raising the possibility of a future public health catastrophe.

TL;DR: This head-to-head trial compared semaglutide with dulag lutide in patients with inadequately controlled type 2 diabetes, finding that gastrointestinal disorders were the most frequently reported adverse event and bodyweight superiority was powered for HbA1c non-inferiority and body weight superiority.

TL;DR: Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist that is not cleared by the kidneys, and confers a lower risk of hypoglycaemia than does insulin, and is assessed in patients with type 2 diabetes and moderate-to-severe chronic kidney disease.

TL;DR: The current practice of MR antagonist therapy in primary aldosteronism is associated with significantly higher risk for incident cardiometabolic events and death, independent of blood pressure control, than for patients with essential hypertension.

TL;DR: It is suggested that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density, and there is little justification to use vitamin D supplements to maintain or improve musculoskeletal health.

TL;DR: Even 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.

TL;DR: Compared with CPT, IPT reduced HbA1c in patients with type 2 diabetes and moderate-to-severe periodontitis after 12 months, suggesting that routine oral health assessment and treatment ofperiodontitis could be important for effective management of type 2abetes.

TL;DR: Overweight and obesity, hypertension, and diabetes were highly prevalent in urban and rural Malawi, more so in urban residents, the less poor, and better educated than in rural, the poorest, and least educated participants.

TL;DR: A substantial number of cancer cases are attributable to diabetes and high BMI, and clinical and public health efforts should focus on identifying optimal preventive and screening measures for whole populations and individual patients.

TL;DR: The results suggest that resistant hypertension is commonly a salt-retaining state, most likely due to inappropriate aldosterone secretion, and Mineralocorticoid receptor blockade by spironolactone overcomes the salt retention and resistance of hypertension to treatment.

TL;DR: The safety and efficacy of the addition of the once-weekly GLP-1 receptor agonist dulaglutide to the ongoing treatment regimen in patients whose diabetes is inadequately controlled with SGLT2 inhibitors, with or without metformin is assessed.

TL;DR: Trends in the prevalence of diabetes in the region are detailed and major determinants of the disease in the context of nutrition and physical activity transitions and the south Asian phenotype are addressed.

TL;DR: An exploratory analysis of ELIXA investigated percentage change in urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) according to prespecified albuminuria status at baseline and associated lixisenatide was associated with a reduced risk of new-onset macroalbuminuria.

TL;DR: Much research is needed before precision nutrition can be widely used in clinical and public health settings, including a lack of robust and reproducible results, the high cost of omics technologies, and methodological issues in study design as well as high-dimensional data analyses and interpretation.

TL;DR: The effects of age on the different hypothalamic-pituitary-hormonal organ axes, as well as age-related changes in calcium and bone metabolism and glucose homoeostasis are discussed.

TL;DR: Denosumab was both non-inferior and superior to risedronate at 12 months for effect on bone mineral density at the lumbar spine in both glucocorticoid-continuing and glucocortex-initiating subpopulations.

TL;DR: In this article, the authors 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) are modified by diabetes.

TL;DR: The cardiovascular and renal burdens in adults with prediabetes over time and compared patterns with other glycaemic status groups are examined using data from the NHANES between 1988 and 2014.

TL;DR: In patients in whom the renin-angiotensin system is already maximally blocked, the addition of neprilysin inhibition attenuates the effect of diabetes to accelerate the deterioration of renal function that occurs in patients with chronic heart failure.

TL;DR: Evidence indicating a key role for the hypothalamic-pituitary axis in the pathogenesis of frailty through aberrant regulation of glucocorticoid secretion, insulin-like growth factor signalling, and androgen production is summarized.

TL;DR: Mortality increased substantially with increasing HbA1c variability in all models (overall and for both sexes) and the level of variability also seems to be an important factor, suggesting that a stable glycaemic level in the middle range is associated with lower risk.

TL;DR: For the indications assessed in this study, islet transplantation effectively improves metabolic outcomes and seems to be a valid option for patients with severe, unstable type 1 diabetes who are not responding to intensive medical treatments.

TL;DR: This trial aimed to compare the efficacy and safety of add-on mycophenolate to methylprednisolone in comparison with methylpredisonsolone alone in patients with moderate-to-severe Graves' orbitopathy.

TL;DR: This Review contrasts 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.

TL;DR: The aim was to examine the availability and affordability of metformin, sulfonylureas, and insulin across multiple regions of the world and explore the effect of these on medicine use, and to estimate affordability of medicines using income data from household surveys.

TL;DR: Ten-year multicentre follow-up study of a large international cohort of patients with KCNJ11 permanent neonatal diabetes to address the key questions relating to long-term efficacy and safety of sulfonylureas in these patients, with main outcomes of interest sulfONYlurea failure, defined as permanent reintroduction of daily insulin, and metabolic control, specifically HbA1c and sulfonyLurea dose.