Diabetes

Reductions in blood glucose levels in people with diabetes are often achieved at the expense of increased hypoglycemia. A novel approach is to automatically deliver microdose glucagon when automation of insulin delivery alone is not sufficient to prevent hypoglycemia. The approach requires a bihormonal device and a stable form of glucagon or glucagon analog. The

Currently, the gold standard for diagnosing diabetic kidney disease (DKD) is the measurement of the urinary albumin-to-creatinine ratio (UACR), but it has been clarified that there are many cases of decreased renal function and atypical nephropathy without the development of albuminuria (1,2). Given these diversified pathologies of DKD, it is necessary to identify new biomarkers

Effective management of diabetes during the coronavirus disease 2019 (COVID-19) pandemic is critical given that hyperglycemia is both a risk factor for infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been associated with poorer outcomes for those infected (1). Unfortunately, inadequate diabetes self-management due to medication nonadherence is prevalent among patients

Stroke is a leading cause of death and disability for people with diabetes. Managing elevated hemoglobin A1C levels, high blood pressure, and high cholesterol can reduce the risk for stroke. Richard Benson, MD, PhD, is director of the Office of Global Health and Health Disparities at the National Institute of Neurological Disorders and Stroke (NINDS).

We thank Dr. Gastadelli and colleagues for their interest in our review article (1) and their comments (2) on the limitations of different approaches to assessing insulin clearance in humans and putative limitations of the hypothesis (3) that lower insulin clearance might cause type 2 diabetes (T2D). In fact, many of their comments relate to

We read with interest the review by Piccinini and Bergman (1) that 1) argues for superiority of the Polidori-Bergman model or peripheral-portal infusion technique to estimate the metabolic clearance rate of insulin (MCR-I) over other methods, and 2) hypothesizes that reduced MCR-I causes type 2 diabetes (T2D). Obviously, the peripheral-portal infusion approach is not feasible

We would like to thank Melgoza et al. (1) for their interest in our article (2) and for suggesting the need for more analysis of the relationship of smoking and Parkinson disease (PD). They also suggested the importance of the cholinergic system in protection from PD and also stressed the need for discovery of novel

Estimates based on the National Inpatient Sample (NIS) showed that diabetes-related nontraumatic lower- extremity amputation (NLEA) rates declined among hospitalized patients between 2000 and 2009, followed by an increasing NLEA rate between 2009 and 2015 (1). The increase was largely observed in young and middle-aged adults (1). However, the NIS dataset includes only inpatient admissions;

Metabolic diseases, such as diabetes and obesity, increase susceptibility for additional long-term complications, including Parkinson disease (PD). Rhee et al. (1) aim to address this issue by using a large data set obtained from the Korean National Health Insurance consisting of a sample of over 15 million individuals aged 40 years and older who had

Nontraumatic lower-extremity amputations (NLEAs) are a disabling and costly complication of uncontrolled diabetes (1). Factors influencing NLEAs include glycemic control, vascular disease, foot ulcer, and diabetes prevention practices (2,3). Texas has high rates of underinsured individuals, high prevalence of diabetes, a growing Hispanic population, and high rates of NLEAs (4). We examine trends of lower-extremity

While currently available continuous glucose monitoring (CGM) systems have continually improving accuracy that has revolutionized modern diabetes care, potential medication interferences are recognized for all available CGM systems (1). For Dexcom CGM systems, hydroxyurea was recently recognized as an interfering substance that can falsely elevate sensor glucose (SG) readings (2), but the data demonstrating this

Offspring of women with gestational diabetes mellitus (GDM) exhibit a high risk of developing type 2 diabetes later in life, potentially as a result of developmental programming by epigenetic mechanisms (1,2). We read with great interest the meta-analysis by Howe et al. (3) integrating results of differential cord blood DNA methylation changes from seven epigenome-wide

Clinical research focuses on the relationship between one or more independent variables and some dependent variable or outcome chosen to reflect some underlying process. For categorical variables, the research may either be focused on a specific end point such as myocardial infarction (MI) or on an underlying construct such as vascular disease (with MI as

Cardiac mitochondrial alterations are suspected to play a key role in the development of diabetes-related heart failure as reported in some animal and few human studies in type 2 diabetes (1). It is yet unclear whether these alterations are induced by diabetes-related metabolic changes or develop secondary to other factors underlying heart failure including micro-

How can health care professionals help patients with diabetes and an eating disorder? Disordered eating behaviors are common among individuals with diabetes and can have devastating effects for diabetes management, while diagnostic threshold eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder may affect up to 20% of all people who have

Learn about how diagnosing and treating peripheral arterial disease in people with diabetes can help prevent amputations. Foluso A. Fakorede, MD, a cardiologist in Bolivar County, MS, has used prevention, screening, and treatment strategies to reduce amputations by 88% in the Mississippi Delta area where he practices. Here, Dr. Fakorede discusses risk factors for peripheral

Learn about diabetic foot ulcers, a common and costly complication of diabetes that often leads to lower limb amputation, and the role peripheral arterial disease (PAD) plays in its development and severity. Dr. Edward Boyko and Dr. Matilde Monteiro-Soares are co-authors of the chapter, “Peripheral Arterial Disease, Foot Ulcers, Lower Extremity Amputations, and Diabetes,” in

Garofolo et al. (1) reported that insulin resistance (IR) is an independent predictor of cardiovascular events and coronary artery disease after adjustment for multiple cofounders including diabetic kidney disease in a 10-year prospective cohort study of 774 patients with type 1 diabetes (T1D). They assessed IR by calculating the estimated glucose disposal rate (eGDR) using

We thank Seibold (1) for his interest in our randomized study comparing real-time CGM (rtCGM) and intermittently scanned CGM (isCGM) in patients with type 1 diabetes (T1D) and normal hypoglycemia awareness during physical activity and over the subsequent home phase (2). We acknowledge the challenges associated with using outcomes from the isCGM (FreeStyle Libre) and

The Comparison of CGM in Randomized Study of Real-time and Intermittently Scanned Systems in T1D With Normal Awareness of Hypoglycemia (CORRIDA) study (1) has compared real-time continuous glucose monitoring (rtCGM) and intermittently scanned CGM (isCGM) (also termed flash glucose monitoring) in people with type 1 diabetes (T1D) during a 4-day exercise regimen and over 4

We thank Violante-Cumpa et al. (1) for their comments on our article that showed metformin use in older people with type 2 diabetes (diabetes) mitigated cognitive decline and incident dementia risk (2). We here respond to each comment. First, Violante-Cumpa et al. comment that the metformin group took other glucose-lowering medications (50%) compared with 40%

Most everyone knows that when someone has type 1 diabetes, their pancreas lacks the ability to produce the hormone insulin (or their pancreas doesn’t make enough insulin, as in the case of type 2 diabetes). What isn’t so well known is that the pancreas also produces another helpful hormone called amylin that people with diabetes