MD Conference Express ADA 2012 - (Page 10)

n C L I N I C A L T R I A L H I G H L I G H T S Table 1. Outcomes. Outcome Measure Time in target (110-200 mg/dL overnight; hours) Time >300 mg/dL overnight (hours) AUC >200 mg/dL overnight (mg/dL*hours) Number of interventions for hypoglycemia Peak postprandial glucose (mg/dL) 12:00 PM glucose (mg/dL) SPT 3.20±0.77 1.30±0.42 384±84 4.0 353±24 273±24 CLT 5.30±0.66 0.18±0.08 162±40 5.0 367±23 189±18 p value 0.12 0.035 0.049 1.0 0.71 0.009 from children with diabetes compared with individuals who did not have diabetes. In individuals without type 1 diabetes, SIF, stimulated at 420λ (SIF 420c), increased with chronological age. When adjusted for chronological age and gender, SIF 420c was higher in children with type 1 and type 2 diabetes compared with children without diabetes (Figure 1). Fortythree percent of children with type 1 diabetes and 55% with type 2 diabetes had SIF values that were comparable with those of the adults (who were approximately 27 years older) without diabetes. SIF was associated with HbA1C or hemoglobin glycation index in the children with diabetes, but mean blood glucose levels were not. Figure 1. SIF 420c. 8 7 CLT maintained tight glucose control without increasing the incidence of hypoglycemia and improved pre-lunch blood sugars, leading the investigators to conclude that it has the potential to improve diabetes care for very young children. SIF 420c (RFU x 10-3) 6 5 4 3 2 The Precocious “AGE’ing” Effect of Type 1 Diabetes in Children Written by Phil Vinall Type 1 diabetes mellitus increases the formation of long-lived complexes, known as advanced glycation endproducts (AGEs), which can contribute to the development of complications in patients with diabetes [Genuth S et al. Diabetes 2005]. AGEs accumulate naturally in tissues over time, and tissue burden is a function of chronological age. Shreepal Shah, MD, Louisiana State University, New Orleans, Louisiana, USA, presented results of the "The Precocious “AGE’ing” Effect of Type 1 Diabetes in Children" study, which examined the relationship between chronological age and type 1 diabetes on skin AGEs in children. The study results indicated that a large proportion of children with type 1 and type 2 diabetes have precocious accumulation of skin AGEs, as estimated by skin-intrinsic fluorescence (SIF), compared with children and adults without diabetes. The study was conducted in children with established type 1 (n=133; mean age 13 years) and type 2 diabetes (n=20; mean age 15 years) and healthy children (n=91; mean age 10 years) and adults (n=129; mean age 40 years) without diabetes. The mean duration of diabetes was 6 years for patients with type 1 diabetes and 4 years for those with type 2 diabetes. History of, or current smoking was cause for exclusion. Skin AGEs were estimated noninvasively by measuring SIF using a Scout DS® device using procedures previously described by Felipe et al. [Felipe DL et al. Diabetes Care 2011]. The goal of the study was to assess accumulated skin AGEs, estimated from SIF, 10 August 2012 1 0 Non-DM Children Type 1 DM Children Type 2 DM Children Non-DM Adults DM=diabetes mellitus. Reproduced with permission from S. Shah, MD. Many children with type 1 and type 2 diabetes have estimated skin AGE levels that are comparable with those that would be observed naturally only in adults aged 20 to 40 years. The investigators estimated that 4 to 6 years of diabetes duration is comparable with ~30 years of chronological aging. The authors speculated that factors that predispose individuals to precocious accumulation of skin AGEs may also predispose them to precocious development of diabetes complications. Abatacept in Patients with New-Onset Type 1 Diabetes: One-Year Follow-Up Written by Phil Vinall Type 1 diabetes mellitus (T1DM) is an autoimmune disease that is driven by activated T-lymphocytes. To be fully active, immune T-cells need a costimulatory signal in addition to the main antigen-driven signal. A previous study showed that abatacept, a costimulation modulator that prevents full T-cell activation, slowed reduction in www.mdconferencexpress.com  http://scientificsessions.diabetes.org http://www.mdconferencexpress.com

Table of Contents for the Digital Edition of MD Conference Express ADA 2012

MD Conference Express ADA 2012
Contents
ORIGIN Trial Results
New Lessons in Hypertension and Diabetes
Closed-Loop Insulin Therapy in Young Children
The Precocious “AGE’ing” Effect of Type 1 Diabetes in Children
Abatacept in Patients with New-Onset Type 1 Diabetes: One-Year Follow-Up
Explaining the UKPDS Legacy Effect
Insulin and Cancer
Insulin Analogs
Dyslipidemia
Insulin Therapy
Incretin Therapies
Diabetes and Chronic Kidney Disease Guidelines Update
Managing Hyperglycemia in Hospitalized Patients
CVD Prevention and Treatment in Women With Diabetes
China Da Qing Study: Lifestyle Change in Women With IGT Extends Life
Markers of Macrovascular Complications in Pediatric Diabetes
Nonoperative Management of the Infected Diabetic Foot
Diabetic Retinopathy: Changing Prevalence and Severity Require Flexible Interventions
New ADA/EASD Position Statement Endorses a Patient-Centered Approach

MD Conference Express ADA 2012

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