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Spotlight on... awareness weeks

Awareness weeks guide

National Diabetes Week

National Diabetes Week

14 – 21 July, 2024

People living with diabetes should be able to access the life-saving technology they need to live well. This year we are shining a light on the impact of diabetes tech and what needs to be done to improve access. Diabetes Australia 

UpToDate

Adults – Diagnosis and screening

Adults - Treatment

Complications

General

Gestational diabetes mellitus

Paediatrics – Diagnosis and screening

Paediatrics – Treatment

Cochrane Library

Guidelines

Patient resources

Reports

Articles

Gestational Diabetes

Research

Technology

Treatments and interventions

E-books

E-journals

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Articles

Gestational Diabetes

Identification and validation of gestational diabetes subgroups by data-driven cluster analysis
The findings of this study confirm the heterogeneity of GDM. The identification of subgroups (clusters) has the potential to help clinicians define more tailored treatment approaches for improved maternal and neonatal outcomes. Diabetologia 27 May 2024

Progression of diabetic retinopathy in women with pregestational diabetes during pregnancy and postpartum
Nearly 1 in 4 women had Diabetic retinopathy (DR) progression from conception through to 12-months postpartum; almost half of these developing sight-threatening disease. DR progression occurring during pregnancy was found to predominantly remain unchanged, or worsen, after delivery, with very few eyes spontaneously improving postpartum. Clinical & experimental ophthalmology 19 June 2024

Establishing causal relationships between insomnia and Gestational Diabetes Mellitus using Mendelian randomization
This study indicates that insomnia elevates the risk of Gestational diabetes mellitus (GDM), thereby establishing a causal link with GDM, independent of coffee consumption, alcohol intake, and household income. Heliyon 25 June 2024

Effect of gestational diabetes on fetal growth rate and later overweight in the offspring
Pregnancies affected by Gestational diabetes mellitus (GDM) had higher fetal growth rate and the offspring had a higher risk of being overweight at 5-9 years. Fetal growth rate in early third trimester was a mediator of up to 15% of this association, but pre-pregnancy BMI contributed strongly as well. The journal of clinical endocrinology & metabolism 25 June 2024

Effect of perinatal consumption of low-calorie sweetener on maternal health: A systematic review and meta-analysis
Based on the evidence available, low-calorie (or artificial) sweetener (LCS) consumption in pregnancy was associated with increased risk of preterm birth and gestational diabetes. Robust research, such as well-designed randomized trials and large prospective cohort studies, is required to confirm the causal effect of LCS consumption during perinatal period on adverse maternal health outcomes. Clinical Nutrition ESPEN 25 June 2024

The experiences of individuals who have had gestational diabetes: A qualitative exploration
What's new

  • The incidence of gestational diabetes mellitus (GDM) is increasing, and there have been changes in the service landscape over time that may be contributing to changes in GDM care experiences.
  • This qualitative study highlights the experiences of individuals with GDM in Australia, including unmet needs and preferences at the health system, interpersonal, and individual levels.
  • Study findings suggest a need to reconfigure healthcare services, with the potential help of digital tools. We need to better respond to individual care needs and address stigma, for example, via person-centred care, participation in clinical decision making, tailored approaches and public and professional awareness of GDM.

Diabetic medicine 9 June 2024

Mid-upper arm circumference predicts the risk of gestational diabetes in early pregnancy
Pregnant women with  mid-upper arm circumference (MUAC)  >28.5 cm are prone to develop GDM during pregnancy, indicating that MUAC as an important predictive factor of gestational diabetes mellitus (GDM) in early pregnancy. BMC pregnancy and childbirth 4 July 2024

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Research

International guideline comparison of lifestyle management for acute coronary syndrome and type 2 diabetes mellitus: a rapid review
Highlights

  • Type 2 diabetes mellitus (T2DM) increases risk of acute coronary syndrome (ACS).
  • Currently, both conditions are managed separately and exclusively, despite shared disease determinants.
  • Opportunities for optimised and integrated management of comorbid ACS-T2DM are identified.
  • Combination of nutrition, physical activity, weight, clinical and psychological management is possible.

Health policy 20 June 2024

Caesarean section and risk of type 1 diabetes
Caesarean section increased the rate of progression to stage 3 type 1 diabetes in children with pre-symptomatic early-stage type 1 diabetes. Diabetologia 31 May 2024

COVID-19 vaccine acceptance, hesitancy, and uptake in people with Diabetes in Australia
Despite an overall high vaccination rate, general and diabetes-specific COVID-19 vaccine concerns are a barrier to uptake for some people with diabetes, particularly in those who are younger or have type 1 diabetes. A detailed understanding of concerns for particular subgroups can help tailor information to increase vaccine acceptance, particularly in the context of requiring booster doses. Vaccines 16 June 2024

Staphylococcus aureus is the predominant pathogen in hospitalised patients with Diabetes-related foot infections: An Australian perspective
Diabetes prevalence continues to increase worldwide, which has led to a rising incidence of diabetes-related foot infections (DFIs). There is significant local variation in the microbiology of DFIs, and Pseudomonas spp. is suggested to be more prevalent in subtropical climates. The aim of this study was to investigate the local microbiological findings in patients admitted to the hospital with DFIs. Antibiotics 26 June 2024

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Technology

The role of automated insulin delivery technology in diabetes
The role of automated insulin delivery systems in diabetes is expanding. Hybrid closed-loop systems are being used in routine clinical practice for treating people with type 1 diabetes. Encouragingly, real-world data reflects the performance and usability observed in clinical trials. The authors review the commercially available hybrid closed-loop systems, their distinctive features and the associated real-world data. We also consider emerging indications for closed-loop systems, including the treatment of type 2 diabetes where variability of day-to-day insulin requirements is high, and other challenging applications for this technology. They also discuss issues around access and implementation of closed-loop technology, and consider the limitations of present closed-loop systems, as well as innovative approaches that are being evaluated to improve their performance. Diabetologia 13 May 2024

Outcomes and experiences of families with children with type 1 diabetes on insulin pumps through subsidised pump access programs in Western Australia
Children with T1D who commenced insulin pump therapy on subsidised pathways maintained glycaemic control for two years, and families favored pumps as a management option. However, financial limitations persist as a significant barrier to procure and continue pump therapy. Pathways for access need to be assessed and advocated. Frontiers in endocrinology 8 June 2023

Long-term improvements in Glycemic control with Dexcom CGM use in adults with non-insulin-treated type 2 Diabetes
In this large, real-world study of adults with suboptimally controlled type 2 diabetes (T2DM) not using insulin, Dexcom continuing glucose monitoring (CGM) use was associated with meaningful improvements in glycemic control over 12 months. Use of the high alert system feature was positively associated with glycemic outcomes. High use of CGM over 12 months suggests benefits related to consistent CGM use in this population. Diabetes technology & therapeutics 21 June 2024

Continuous Glucose monitoring metrics in high-risk pregnant women with Type 2 Diabetes
In this high-risk group of women with type 2 diabetes (T2DM), continuous glucose monitoring (CGM) metrics only improved during pregnancy in those with greater sensor use and were associated with large for gestational age (LGA) in early pregnancy and neonatal hypoglycemia throughout. Culturally appropriate health care strategies are critical for successful use of CGM technology. Diabetes technology & therapeutics 23 November 2023

Longitudinal trends in Glycemic outcomes and technology use for over 48,000 people with Type 1 Diabetes (2016–2022) from the T1D exchange quality improvement collaborative
Population-level data on outcomes, including HbA1c, can provide trends and insights into strategies to improve health for PwT1D. The T1DX-QI cohort showed a significant improvement in HbA1c from 2016 to 2022. Improvements in diabetes device use are also demonstrated. However, these increases were inconsistent across all racial/ethnic groups or insurance types, an important focus for future T1D population health improvement work. Diabetes technology & therapeutics 7 November 2023

Modifiable factors to prevent severe hypoglycaemic and diabetic ketoacidosis presentations in people with type 1 diabetes
Improving access to continuous glucose monitoring and insulin pump therapy, in combination with ongoing diabetes education focusing on symptom recognition and early management, will reduce the incidence of diabetes-related emergencies. Concurrent research assessing emergency healthcare usage patterns during the implementation of such measures is essential to ensure these are cost-effective. Diabetes medicine 24 June 2024

Advancements in oral insulin: A century of research and the emergence of targeted nanoparticle strategies
This review provides a summary of recent progress in oral insulin delivery, particularly highlighting surface-modified functional nanoparticles serving as an effective drug delivery system, which offers valuable information to the researchers. Due to the limited effectiveness of oral protein drugs caused by biological barriers, innovative technologies and drug delivery systems have been developed to overcome these obstacles and achieve therapeutic goals. This review concluded that surface modifications to nanoparticles can improve insulin stability and permeability, thereby enhancing oral bioavailability. It could assist researchers in developing more effective and patient-friendly oral drug delivery systems. European journal of lipid science and technology 16 June 2024

Equity in type 1 diabetes technology and beyond: where are we in 2022?
The uptake of diabetes technology, such as continuous glucose monitoring (CGM), insulin pumps and automated insulin delivery, is rapidly increasing in people with type 1 diabetes (T1D), particularly in young people with T1D. Diabetes technology has the potential to be a game-changer, offering improved glycemic control and better psychosocial outcomes. However, it is crucial to acknowledge the existing disparities that hinder equitable access to these advancements. Frontiers in endocrinology 24 March 2024

Following in Banting’s footsteps or straying from the path? Observations from contemporary diabetes innovation
While advancements in the treatment of diabetes continue to rapidly evolve, many of the newer technologies have financial barriers to care, opposing the egalitarian ethos of Banting who sold his patent on insulin for a nominal cost to allow it to be made widely available. Inequity in access to new therapies drives disparity in diabetes burden with potential for these gaps to widen in the future. The 2023 International Conference on Advanced Technologies and Treatments of Diabetes (ATTD) presented ground-breaking and current research in diabetes technology. Oral presentations of the ATTD conference 2023 were analyzed to describe what percentage of speakers discussed equity in their talks. Overall, less than a quarter of presenters discussed equity, though there was regional variation. To ensure that diabetes technologies reduce disparity and improve outcomes, we encourage future speakers at diabetes (technology) conferences to consider equity of diabetes care and incorporate this into their presentations. Frontiers in endocrinology 14 November 2023

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Treatments and interventions

Challenges and opportunities in precision therapy for Diabetic patients
More than 463 million persons worldwide suffer from diabetes, one of the health issues with the fastest-growing occurrences in the twenty-first century. Over the past 20 years, the prevalence of diabetes has increased by three times, and it is predicted that 700 million adults will be affected by it by 2050. There are still barriers to the widespread adoption of precision medicine, even though doing so can enhance patient-centred outcomes and save costs. To strengthen the potential to deploy and enhance precision diabetes detection methodologies across the general population, it is crucial to address research gaps in upcoming epidemiological investigations. Health sciences review 2 July 2024 

A 5:2 intermittent fasting meal replacement diet and glycemic control for adults with Diabetes : The EARLY randomized clinical trial
The 5:2 MR approach may serve as an effective initial lifestyle intervention instead of antidiabetic drugs for patients with type 2 diabetes. JAMA 21 June 2024

Subcutaneously administered tirzepatide vs semaglutide for adults with type 2 diabetes: a systematic review and network meta-analysis of randomised controlled trials
The data show that s.c. tirzepatide had a more pronounced effect on HbA1c and weight reduction compared with s.c. semaglutide in people with type 2 diabetes. Both drugs, particularly higher doses of tirzepatide, increased gastrointestinal adverse events. Diabetologia 13 April 2024

Sex and age differences in the use of medications for diabetes and cardiovascular risk factors among 25,733 people with diabetes
Practitioners should be aware of possible sex disparities in the pharmacological treatment of diabetes and cardiovascular risk factors in people with diabetes in Australia. There is a possible time lag between reporting of research findings and uptake of sodium glucose co-transporter 2 inhibitors prescribing in individuals with diabetes and high cardiovascular risk in clinical practice, nevertheless, the result observed was consistent with the management guidelines at the time of the study. Plos one 23 October 2023

SGLT-2 inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors and risk of hyperkalemia among people with type 2 diabetes in clinical practice: population based cohort study
In people with type 2 diabetes, SGLT-2 inhibitors and GLP-1 receptor agonists were associated with a lower risk of hyperkalemia than DPP-4 inhibitors in the overall population and across relevant subgroups. The consistency of associations among individual agents in the SGLT-2 inhibitor and GLP-1 receptor agonist classes suggests a class effect. These ancillary benefits of SGLT-2 inhibitors and GLP-1 receptor agonists further support their use in people with type 2 diabetes, especially in those at risk of hyperkalemia. BMJ 26 June 2024

The effect of educational intervention based on the behavioral reasoning theory on self-management behaviors in type 2 diabetes patients: a randomized controlled trial
The results of this study were in favor of the effectiveness of an educational intervention that promotes diabetes self-management behaviors, using the principles of the behavioral reasoning theory. Which can be used in the design of health promotion programs for patients with diabetes. BMC public health 2 July 2024

Effects of Semaglutide on chronic kidney disease in patients with Type 2 Diabetes
Semaglutide reduced the risk of clinically important kidney outcomes and death from cardiovascular causes in patients with type 2 diabetes and chronic kidney disease. NEJM 24 May 2024 

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E-books

This is just a sample of the e-books the library subscribes to – you will need your library login

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E-Journals

A sample of the journals the library subscribes to – you will need your library login

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