tri Multimodality Imaging of Inflammation and Ventricular Remodeling in Pressure-Overload Heart Failure By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 Inflammation contributes to ventricular remodeling after myocardial ischemia, but its role in nonischemic heart failure is poorly understood. Local tissue inflammation is difficult to assess serially during pathogenesis. Although 18F-FDG accumulates in inflammatory leukocytes and thus may identify inflammation in the myocardial microenvironment, it remains unclear whether this imaging technique can isolate diffuse leukocytes in pressure-overload heart failure. We aimed to evaluate whether inflammation with 18F-FDG can be serially imaged in the early stages of pressure-overload–induced heart failure and to compare the time course with functional impairment assessed by cardiac MRI. Methods: C57Bl6/N mice underwent transverse aortic constriction (TAC) (n = 22), sham surgery (n = 12), or coronary ligation as an inflammation-positive control (n = 5). MRI assessed ventricular geometry and contractile function at 2 and 8 d after TAC. Immunostaining identified the extent of inflammatory leukocyte infiltration early in pressure overload. 18F-FDG PET scans were acquired at 3 and 7 d after TAC, under ketamine-xylazine anesthesia to suppress cardiomyocyte glucose uptake. Results: Pressure overload evoked rapid left ventricular dilation compared with sham (end-systolic volume, day 2: 40.6 ± 10.2 μL vs. 23.8 ± 1.7 μL, P < 0.001). Contractile function was similarly impaired (ejection fraction, day 2: 40.9% ± 9.7% vs. 59.2% ± 4.4%, P < 0.001). The severity of contractile impairment was proportional to histology-defined myocardial macrophage density on day 8 (r = –0.669, P = 0.010). PET imaging identified significantly higher left ventricular 18F-FDG accumulation in TAC mice than in sham mice on day 3 (10.5 ± 4.1 percentage injected dose [%ID]/g vs. 3.8 ± 0.9 %ID/g, P < 0.001) and on day 7 (7.8 ± 3.7 %ID/g vs. 3.0 ± 0.8 %ID/g, P = 0.006), though the efficiency of cardiomyocyte suppression was variable among TAC mice. The 18F-FDG signal correlated with ejection fraction (r = –0.75, P = 0.01) and ventricular volume (r = 0.75, P < 0.01). Western immunoblotting demonstrated a 60% elevation of myocardial glucose transporter 4 expression in the left ventricle at 8 d after TAC, indicating altered glucose metabolism. Conclusion: TAC induces rapid changes in left ventricular geometry and contractile function, with a parallel modest infiltration of inflammatory macrophages. Metabolic remodeling overshadows inflammatory leukocyte signal using 18F-FDG PET imaging. More selective inflammatory tracers are requisite to identify the diffuse local inflammation in pressure overload. Full Article
tri First-in-Humans Imaging with 89Zr-Df-IAB22M2C Anti-CD8 Minibody in Patients with Solid Malignancies: Preliminary Pharmacokinetics, Biodistribution, and Lesion Targeting By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 Immunotherapy is becoming the mainstay for treatment of a variety of malignancies, but only a subset of patients responds to treatment. Tumor-infiltrating CD8-positive (CD8+) T lymphocytes play a central role in antitumor immune responses. Noninvasive imaging of CD8+ T cells may provide new insights into the mechanisms of immunotherapy and potentially predict treatment response. We are studying the safety and utility of 89Zr-IAB22M2C, a radiolabeled minibody against CD8+ T cells, for targeted imaging of CD8+ T cells in patients with cancer. Methods: The initial dose escalation phase of this first-in-humans prospective study included 6 patients (melanoma, 1; lung, 4; hepatocellular carcinoma, 1). Patients received approximately 111 MBq (3 mCi) of 89Zr-IAB22M2C (at minibody mass doses of 0.2, 0.5, 1.0, 1.5, 5, or 10 mg) as a single dose, followed by PET/CT scans at approximately 1–2, 6–8, 24, 48, and 96–144 h after injection. Biodistribution in normal organs, lymph nodes, and lesions was evaluated. In addition, serum samples were obtained at approximately 5, 30, and 60 min and later at the times of imaging. Patients were monitored for safety during infusion and up to the last imaging time point. Results: 89Zr-IAB22M2C infusion was well tolerated, with no immediate or delayed side effects observed after injection. Serum clearance was typically biexponential and dependent on the mass of minibody administered. Areas under the serum time–activity curve, normalized to administered activity, ranged from 1.3 h/L for 0.2 mg to 8.9 h/L for 10 mg. Biodistribution was dependent on the minibody mass administered. The highest uptake was always in spleen, followed by bone marrow. Liver uptake was more pronounced with higher minibody masses. Kidney uptake was typically low. Prominent uptake was seen in multiple normal lymph nodes as early as 2 h after injection, peaking by 24–48 h after injection. Uptake in tumor lesions was seen on imaging as early as 2 h after injection, with most 89Zr-IAB22M2C–positive lesions detectable by 24 h. Lesions were visualized early in patients receiving treatment, with SUV ranging from 5.85 to 22.8 in 6 target lesions. Conclusion: 89Zr-IAB22M2C imaging is safe and has favorable kinetics for early imaging. Biodistribution suggests successful targeting of CD8+ T-cell–rich tissues. The observed targeting of tumor lesions suggests this may be informative for CD8+ T-cell accumulation within tumors. Further evaluation is under way. Full Article
tri Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial By feeds.bmj.com Published On :: Wednesday, March 25, 2020 - 22:31 Full Article
tri Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials By feeds.bmj.com Published On :: Wednesday, April 1, 2020 - 22:31 Full Article
tri Prospective registration and reporting of trial number in randomised clinical trials: global cross sectional study of the adoption of ICMJE and Declaration of Helsinki recommendations By feeds.bmj.com Published On :: Tuesday, April 14, 2020 - 09:20 Full Article
tri Making the Business Case for Nutrition Workshop By feedproxy.google.com Published On :: Thu, 05 Dec 2019 12:15:01 +0000 Invitation Only Research Event 28 January 2020 - 9:30am to 5:00pm Chatham House | 10 St James's Square | London | SW1Y 4LE A ground-breaking research project from Chatham House, supported by The Power of Nutrition, is exploring the business case for tackling undernutrition, micronutrient deficiencies and overnutrition. Companies across all sectors hold huge, transformative power to save countless lives and transform their own financial prospects. To act, they need more compelling evidence of the potential for targeted investments and strategies to promote better nutrition and create healthier, more productive workforces and consumers.At this workshop, Chatham House will engage business decision-makers in a scenario exercise that explores different nutrition futures and their commercial prospects in each before examining what different strategies business can pursue to maximize future profitability through investments in nutrition.Attendance at this event is by invitation only. Department/project Energy, Environment and Resources Programme Full Article
tri Climate Change, Energy Transition, and the Extractive Industries Transparency Initiative (EITI) By feedproxy.google.com Published On :: Thu, 05 Dec 2019 15:45:01 +0000 Invitation Only Research Event 17 January 2020 - 9:30am to 5:00pm Chatham House | 10 St James's Square | London | SW1Y 4LE Climate change and energy transition are re-shaping the extractive sectors, and the opportunities and risks they present for governments, companies and civil society. As the central governance standard in the extractives sector, the EITI has a critical role in supporting transparency in producer countries.This workshop will bring together experts from the energy and extractives sectors, governance and transparency, and climate risk and financial disclosure initiatives to discuss the role of governance and transparency through the transition. It will consider the appropriate role for the EITI and potential entry points for policy and practice, and the potential for coordination with related transparency and disclosure initiatives. Please note attendance is by invitation only. Department/project Energy, Environment and Resources Programme Full Article
tri Joining Up the Dots: Energy and Infrastructure for Countries in Crisis By feedproxy.google.com Published On :: Mon, 16 Dec 2019 12:53:31 +0000 16 December 2019 Glada Lahn Senior Research Fellow, Energy, Environment and Resources Programme @Glada_Lahn Suzanna Huber Hajar Al-Kaddo Could a refugee crisis help the host-country improve its health and development outcomes? The ‘energy and infrastructure’ focus at this week’s first UN Global Refugee Forum suggests it could, where national policy enables it. Practical action RV0_1139.jpg A man serves customers at a shop in Nyahbiheke Refugee Camp, Rwanda. Energy access makes it possible for refugees to power and run businesses. Photo: Practical Action. Mass human displacement crises like those in Syria, Democratic Republic of Congo and Myanmar do not dissipate within a year or two. The average age of a refugee camp globally is 18 and counting.Meanwhile, the pressures on resources and services in neighbouring countries absorbing an influx of vulnerable people can be harsh. Imagine the overstressed schools and hospitals where intake has doubled in areas of Jordan and Lebanon, and the damage to ecosystems and elephant habitats where camps have sprung up in Bangladesh. The fallout from such crises is prompting new ways of working in the international humanitarian system. These recognize that short-term, emergency responses can jeopardize national development goals if maintained indefinitely. In most refugee camps for instance, each family cooks with wood in regions already suffering from deforestation.Reliance on polluting trucks to bring in fuel and water is high. At the same time, developing countries – which host 80 per cent of the record 70.8 million people currently displaced by conflict – desperately need to address health, water, energy and housing needs for their own populations. Aid and welfare interventions directed only at refugees can provoke frustrations amongst the local community, damaging social cohesion and fostering political instability. The Global Compact on Refugees, affirmed by the United Nations General Assembly one year ago, aims at fairer responsibility-sharing amongst countries and equitable resourcing to host communities and refugees. The Global Refugee Forum (GRF) taking place 17–18 December in Geneva is the starting point for donor pledges and commitments. An opportunity for refugee-hosting countriesAmong the GRF’s 6 focus themes is ‘Energy and Infrastructure’ – a new priority for humanitarian aid and finance. This covers energy, environment, water and sanitation, health, shelter and connectivity – services that are tightly interconnected. In October, the UN Refugee Agency (UNHCR) also launched its first energy strategy, which ‘promotes the transition to clean, renewable energy at refugee camps and hosting sites’.Given this impetus, alongside a growing international focus on speeding up Sustainable Development Goal (SDG) delivery, stabilizing migration and supporting climate resilience, more aid and soft credit for interlinked objectives will become available. Countries hosting refugees have an opportunity; how they approach it will determine the level of support they attract and how effectively it is deployed. Policy conditions are key to successIn a refugee situation, energy access is about much more than keeping warm or cooking food. It is also about connecting with loved ones across borders, safety at night, healthy births and making a living. Due to the lack of long-term funding, maintenance systems or government approvals, failed pilots to introduce for example, solar streetlighting or clean cookstoves, are the norm. To increase their durability and reach, projects need to harness local markets and support national development goals, especially those on access to modern energy for all (SDG 7), protecting ecosystems (SDG 15) and resilient human settlements (SDG 11). Several examples of these are emerging, each with valuable lessons to share. The policy environment, in particular, coordination between authorities, humanitarian agencies and private sector actors, can make or break a project. Beyond the basic conditions of adequate security and refugee acceptance, our research highlights three enabling factors:First: government willingness to engage in long-term response and resilience coordination. Jordan is the most advanced in this with its three-year rolling Response Plan for the Syria Crisis whereby the government works with humanitarian agencies to integrate refugee welfare with national development needs.Here, energy, water and housing needs are specified and have attracted funding. For example, in Irbid, Jordan where over 137,600 Syrian refugees live, the Norwegian Refugee Council, is expanding a programme under the Renewable Energy for Refugees (RE4R) initiative that applies energy efficiency and solar water heating to reduce bills and rents for refugee tenants while adding value for Jordanian homeowners. Second: strong, clear, energy and environment plans and legislation. Signals can be mixed. Jordan’s ‘wheeling’ regulation, allowed UNHCR to reduce its electricity bills through specially built solar plants at Azraq and Zaatari, yet the current freeze on renewable connections has stifled further projects.In Rwanda, the government banned the supply of woodfuel to refugee camps on the basis of concerns about deforestation. The announcement sharpens focus on cleaner cooking.Yet with little guidance on enforcement and the timeframe for change, it is difficult for UNHCR and its partners to plan viable schemes. A reversion to stove and fuel handouts is likely, damaging the potential to create markets for alternative cooking practices in the camps. Third: local fuel prices. Where polluting fuels are subsidized or untaxed, additional subsidy is needed to make cleaner alternatives competitive. The higher prices of diesel in Uganda for example are an incentive for solar projects at Bidi Bidi, the world’s largest refugee settlement.The Gaia Association-UNHCR clean energy programme in Ethiopia’s Western refugee camps has avoided burning some 10,000 tonnes of wood since 2006 through ethanol, but if VAT (which is applied to neither charcoal nor kerosene) were waived, it could scale up commercially. Joining up the dotsMany humanitarian and government dots could be joined up in support of the SDGs. In Rwanda for example, clarity on electrification plans – which appear to cover refugee areas – could allow camp mini-grids to be designed for eventual grid integration. In Jordan, lessons learned from the home upgrading programme could be applied to meet city climate resilience ambitions. Donors at the GRF should support humanitarian operations that leave a positive legacy, increasing the robustness of country infrastructure and systems. Host-country governments should help define and encourage projects that benefit national and refugee populations. This will be critical to both development outcomes and limiting future human suffering. Full Article
tri Government recognises contribution of EU workers to the NHS, says health minister By feeds.bmj.com Published On :: Monday, March 20, 2017 - 07:00 Full Article
tri State and Local Labor Standards Enforcement in Immigrant-Dense Industries By www.migrationpolicy.org Published On :: Tue, 06 Mar 2018 21:26:21 -0500 Marking the release of an MPI report, this discussion focuses on the dynamics in low-wage workplaces and immigration law that have contributed to systematic violations of labor standards and explores new and effective enforcement strategies that state and local governments across the United States are utilizing. Full Article
tri State and Local Labor Standards Enforcement in Immigrant-Dense Industries By www.migrationpolicy.org Published On :: Thu, 15 Mar 2018 19:59:17 -0400 This discussion, featuring California's Labor Commissioner and the head of the Tennessee Bureau of Workers' Compensation, launched a report that examines state innovations in labor standards enforcement in low-wage, immigrant-dense industries. With wage underpayment, payroll fraud, and other violations widespread in industries such as construction and car-washing, the discussion focused on how targeted enforcement can deter practices that hurt native-born and immigrant workers alike, cost state tax revenue, and disadvantage law-abiding employers. Full Article
tri African Countries Relax Short-Term Visa Policies for Chinese in Sign of Increased Openness to China By www.migrationpolicy.org Published On :: Wed, 31 Jul 2019 18:14:34 -0400 China has been Africa’s largest trading partner since 2009, and as commerce and investment have increased, so have flows of people in both directions. With an estimated 1 million to 2 million Chinese migrants across Africa, some countries have relaxed their short-term visa requirements in hopes of facilitating cultural and business exchanges. High levels of Chinese investment do not, however, correlate with more liberal visa policies, as this article explores. Full Article
tri Democratic Republic of the Congo: A Migration History Marked by Crises and Restrictions By www.migrationpolicy.org Published On :: Tue, 19 Apr 2016 14:11:11 -0400 One of the least developed countries in sub-Saharan Africa, the Democratic Republic of the Congo has experienced significant migration outflows and inflows tied to political and economic crises in recent decades. While most Congolese migrants head to neighboring countries, destinations have diversified, with an uptick in those leaving for opportunities in Europe and beyond. This country profile explores historical and contemporary patterns of migration to and from DR Congo. Full Article
tri When Disaster Strikes: Responding to Migrants Caught in Crises By www.migrationpolicy.org Published On :: Wed, 05 Sep 2018 12:08:35 -0400 Migrants displaced by crisis do not benefit from international protection the way that refugees do. This article examines the experiences of labor migrants amid manmade and natural disasters in the Central African Republic, Côte d’Ivoire, Lebanon, Libya, South Africa, and Thailand, as well as stakeholder responses. Research demonstrates the agency and resilience of migrants, who develop flexible solutions in the face of crisis. Full Article
tri Reaching a “Fair Deal” on Talent: Emigration, Circulation, and Human Capital in Countries of Origin By www.migrationpolicy.org Published On :: Tue, 02 Feb 2016 10:39:57 -0500 While skilled migration brings widely acknowledged economic benefits for destination countries and migrants, its impact on countries of origin has been the subject of more debate. Despite a growing consensus that origin countries can benefit from emigration and the circulation of skills, enabling this potential to be fully exploited remains a challenge. This report examines initiatives that develop skills and human capital. Full Article
tri Regional Enforcement: A Profile of Migrants Deported from the United States and Mexico to the Northern Triangle By www.migrationpolicy.org Published On :: Fri, 28 Aug 2015 12:13:52 -0400 Marking the release of an MPI report, speakers on this webinar present an overview of regional immigration enforcement trends, including U.S. and Mexican apprehensions and deportations of both children and adults, along with a demographic, socioeconomic, and criminal profile of child and adult deportees. Full Article
tri Migrants Deported from the United States and Mexico to the Northern Triangle: A Statistical and Socioeconomic Profile By www.migrationpolicy.org Published On :: Mon, 31 Aug 2015 15:46:25 -0400 This report examines the rising numbers of apprehensions and deportations of Central American children and adults by the United States and Mexico, and provides a demographic, socioeconomic, and criminal profile of deportees to El Salvador, Guatemala, and Honduras. The report traces how rising Mexican enforcement is reshaping regional dynamics and perhaps ushering in changes to long-lasting trends in apprehensions. Full Article
tri Regional Enforcement: A Profile of Migrants Deported from the United States and Mexico to the Northern Triangle By www.migrationpolicy.org Published On :: Thu, 03 Sep 2015 18:28:05 -0400 This webinar includes an overview of regional immigration enforcement trends, including U.S. and Mexican apprehensions and deportations of Central American migrants, along with a demographic, socioeconomic, and criminal profile of child and adult deportees. Full Article
tri Sex Difference in Effects of Low-Dose Aspirin on Prevention of Dementia in Patients With Type 2 Diabetes: A Long-term Follow-up Study of a Randomized Clinical Trial By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To evaluate and compare the efficacy of long-term use of low-dose aspirin for the prevention of dementia in men and women. RESEARCH DESIGN AND METHODS This study is a follow-up cohort study of the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial, which was a randomized, open-label, standard care–controlled trial examining the effects of low-dose aspirin on cardiovascular events. We followed up 2,536 Japanese patients with type 2 diabetes (T2D) enrolled in the JPAD trial from 2002 to 2017. The primary outcome of this post hoc analysis was the incidence of dementia, which was defined by the prescription of antidementia drugs or admission due to dementia. RESULTS Among the originally enrolled patients, 2,121 (84%) retained their original allocation. During a median follow-up of 11.4 years, 128 patients developed dementia. The overall effect of low-dose aspirin on the prevention of dementia adjusted for age, sex, and other established risk factors was not significant (hazard ratio [HR] 0.82, 95% CI 0.58–1.16). However, a significant reduction was seen in the risk of dementia in women (HR 0.58, 95% CI 0.36–0.95), but not in men (HR 1.27, 95% CI 0.75–2.13) (Pinteraction = 0.03). CONCLUSIONS Long-term use of low-dose aspirin may reduce the risk for dementia in women with T2D. Full Article
tri Late Relapse of Diabetes After Bariatric Surgery: Not Rare, but Not a Failure By care.diabetesjournals.org Published On :: 2020-02-20T11:55:29-08:00 OBJECTIVE To characterize the status of cardiometabolic risk factors after late relapse of type 2 diabetes mellitus (T2DM) and to identify factors predicting relapse after initial diabetes remission following bariatric surgery to construct prediction models for clinical practice. RESEARCH DESIGN AND METHODS Outcomes of 736 patients with T2DM who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at an academic center (2004–2012) and had ≥5 years’ glycemic follow-up were assessed. Of 736 patients, 425 (58%) experienced diabetes remission (HbA1c <6.5% [48 mmol/mol] with patients off medications) in the 1st year after surgery. These 425 patients were followed for a median of 8 years (range 5–14) to characterize late relapse of diabetes. RESULTS In 136 (32%) patients who experienced late relapse, a statistically significant improvement in glycemic control, number of diabetes medications including insulin use, blood pressure, and lipid profile was still observed at long-term. Independent baseline predictors of late relapse were preoperative number of diabetes medications, duration of T2DM before surgery, and SG versus RYGB. Furthermore, patients who relapsed lost less weight during the 1st year after surgery and regained more weight afterward. Prediction models were constructed and externally validated. CONCLUSIONS While late relapse of T2DM is a real phenomenon (one-third of our cohort), it should not be considered a failure, as the trajectory of the disease and its related cardiometabolic risk factors is changed favorably after bariatric surgery. Earlier surgical intervention, RYGB (compared with SG) and more weight loss (less late weight regain) are associated with less diabetes relapse in the long-term. Full Article
tri Targeting CXCR1/2 Does Not Improve Insulin Secretion After Pancreatic Islet Transplantation: A Phase 3, Double-Blind, Randomized, Placebo-Controlled Trial in Type 1 Diabetes By care.diabetesjournals.org Published On :: 2020-03-20T11:50:34-07:00 OBJECTIVE Reparixin is an inhibitor of CXCR1/2 chemokine receptor shown to be an effective anti-inflammatory adjuvant in a pilot clinical trial in allotransplant recipients. RESEARCH DESIGN AND METHODS A phase 3, multicenter, randomized, double-blind, parallel-assignment study (NCT01817959) was conducted in recipients of islet allotransplants randomized (2:1) to reparixin or placebo in addition to immunosuppression. Primary outcome was the area under the curve (AUC) for C-peptide during the mixed-meal tolerance test at day 75 ± 5 after the first and day 365 ± 14 after the last transplant. Secondary end points included insulin independence and standard measures of glycemic control. RESULTS The intention-to-treat analysis did not show a significant difference in C-peptide AUC at both day 75 (27 on reparixin vs. 18 on placebo, P = 0.99) and day 365 (24 on reparixin vs. 15 on placebo, P = 0.71). There was no statistically significant difference between treatment groups at any time point for any secondary variable. Analysis of patient subsets showed a trend for a higher percentage of subjects retaining insulin independence for 1 year after a single islet infusion in patients receiving reparixin as compared with patients receiving placebo (26.7% vs. 0%, P = 0.09) when antithymocyte globulin was used as induction immunosuppression. CONCLUSIONS In this first double-blind randomized trial, islet transplantation data obtained with reparixin do not support a role of CXCR1/2 inhibition in preventing islet inflammation-mediated damage. Full Article
tri Medical Nutrition Therapy: A Key to Diabetes Management and Prevention By clinical.diabetesjournals.org Published On :: 2010-12-01 Sara F. MorrisDec 1, 2010; 28:12-18Feature Articles Full Article
tri Within-Trial Evaluation of Medical Resources, Costs, and Quality of Life Among Patients With Type 2 Diabetes Participating in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To compare medical resource use, costs, and health utilities for 14,752 patients with type 2 diabetes who were randomized to once-weekly exenatide (EQW) or placebo in addition to usual diabetes care in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL). RESEARCH DESIGN AND METHODS Medical resource use data and responses to the EuroQol 5-Dimension (EQ-5D) instrument were collected at baseline and throughout the trial. Medical resources and medications were assigned values by using U.S. Medicare payments and wholesale acquisition costs, respectively. Secondary analyses used English costs. RESULTS Patients were followed for an average of 3.3 years, during which time those randomized to EQW experienced 0.41 fewer inpatient days (7.05 vs. 7.46 days; relative rate ratio 0.91; P = 0.05). Rates of outpatient medical visits were similar, as were total inpatient and outpatient costs. Mean costs for nonstudy diabetes medications over the study period were ~$1,600 lower with EQW than with placebo (P = 0.01). Total within-study costs, excluding study medication, were lower in the EQW arm than in the placebo arm ($28,907 vs. $30,914; P ≤ 0.01). When including the estimated cost of EQW, total mean costs were significantly higher in the EQW group than in the placebo group ($42,697 vs. $30,914; P < 0.01). With English costs applied, mean total costs, including exenatide costs, were £1,670 higher in the EQW group than the placebo group (£10,874 vs. £9,204; P < 0.01). There were no significant differences in EQ-5D health utilities between arms over time. CONCLUSIONS Medical costs were lower in the EQW arm than the placebo arm, but total costs were significantly higher once the cost of branded exenatide was incorporated. Full Article
tri Dietary Nonheme, Heme, and Total Iron Intake and the Risk of Diabetes in Adults: Results From the China Health and Nutrition Survey By care.diabetesjournals.org Published On :: 2020-03-20T11:50:34-07:00 OBJECTIVE Excessive iron intake has been linked to diabetes risk. However, the evidence is inconsistent. This study examined the association between dietary heme and nonheme iron intake and diabetes risk in the Chinese population. RESEARCH DESIGN AND METHODS We included 17,026 adults (8,346 men and 8,680 women) who were part of the China Health and Nutrition Survey (1991–2015) prospective cohort. Dietary intake was measured by three consecutive 24-h dietary recalls combined with a household food inventory. Diabetes cases were identified through a questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS A total of 547 men and 577 women developed diabetes during 202,138 person-years of follow-up. For men, the adjusted HRs (95% CIs) for quintiles of nonheme iron intake were 1.00, 0.77 (0.58–1.02), 0.72 (0.54–0.97), 0.63 (0.46–0.85), and 0.87 (0.64–1.19) (P-nonlinearity = 0.0015). The corresponding HRs (95% CIs) for women were 1.00, 0.63 (0.48–0.84), 0.57 (0.43–0.76), 0.58 (0.43–0.77), and 0.67 (0.49–0.91) (P-nonlinearity < 0.0001). The dose-response curves for the association between nonheme iron and total iron intake and diabetes followed a reverse J shape in men and an L shape in women. No significant associations were observed between heme iron intake and diabetes risk. CONCLUSIONS Total iron and nonheme iron intake was associated with diabetes risk, following a reverse J-shaped curve in men and an L-shaped curve in women. Sufficient intake of nonheme or total iron might be protective against diabetes, while excessive iron intake might increase the risk of diabetes among men. Full Article
tri Diabetes Prevalence and Its Relationship With Education, Wealth, and BMI in 29 Low- and Middle-Income Countries By care.diabetesjournals.org Published On :: 2020-03-20T11:50:34-07:00 OBJECTIVE Diabetes is a rapidly growing health problem in low- and middle-income countries (LMICs), but empirical data on its prevalence and relationship to socioeconomic status are scarce. We estimated diabetes prevalence and the subset with undiagnosed diabetes in 29 LMICs and evaluated the relationship of education, household wealth, and BMI with diabetes risk. RESEARCH DESIGN AND METHODS We pooled individual-level data from 29 nationally representative surveys conducted between 2008 and 2016, totaling 588,574 participants aged ≥25 years. Diabetes prevalence and the subset with undiagnosed diabetes was calculated overall and by country, World Bank income group (WBIG), and geographic region. Multivariable Poisson regression models were used to estimate relative risk (RR). RESULTS Overall, prevalence of diabetes in 29 LMICs was 7.5% (95% CI 7.1–8.0) and of undiagnosed diabetes 4.9% (4.6–5.3). Diabetes prevalence increased with increasing WBIG: countries with low-income economies (LICs) 6.7% (5.5–8.1), lower-middle-income economies (LMIs) 7.1% (6.6–7.6), and upper-middle-income economies (UMIs) 8.2% (7.5–9.0). Compared with no formal education, greater educational attainment was associated with an increased risk of diabetes across WBIGs, after adjusting for BMI (LICs RR 1.47 [95% CI 1.22–1.78], LMIs 1.14 [1.06–1.23], and UMIs 1.28 [1.02–1.61]). CONCLUSIONS Among 29 LMICs, diabetes prevalence was substantial and increased with increasing WBIG. In contrast to the association seen in high-income countries, diabetes risk was highest among those with greater educational attainment, independent of BMI. LMICs included in this analysis may be at an advanced stage in the nutrition transition but with no reversal in the socioeconomic gradient of diabetes risk. Full Article
tri Lipid and Inflammatory Cardiovascular Risk Worsens Over 3 Years in Youth With Type 2 Diabetes: The TODAY clinical trial By care.diabetesjournals.org Published On :: 2013-06-01 TODAY Study GroupJun 1, 2013; 36:1758-1764TODAY Study Full Article
tri Kidney Disease and Related Findings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study By care.diabetesjournals.org Published On :: 2014-01-01 Ian H. de BoerJan 1, 2014; 37:24-30DCCT/EDIC 30th Anniversary Summary Findings Full Article
tri New Insulin Glargine 300 Units/mL Versus Glargine 100 Units/mL in People With Type 2 Diabetes Using Oral Agents and Basal Insulin: Glucose Control and Hypoglycemia in a 6-Month Randomized Controlled Trial (EDITION 2) By care.diabetesjournals.org Published On :: 2014-12-01 Hannele Yki-JärvinenDec 1, 2014; 37:3235-3243Emerging Technologies and Therapeutics Full Article
tri Phase 3 Trial of Transplantation of Human Islets in Type 1 Diabetes Complicated by Severe Hypoglycemia By care.diabetesjournals.org Published On :: 2016-07-01 Bernhard J. HeringJul 1, 2016; 39:1230-1240Emerging Technologies and Therapeutics Full Article
tri Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial By care.diabetesjournals.org Published On :: 2014-05-01 Roman HovorkaMay 1, 2014; 37:1204-1211Advances in Artificial Pancreas Development Full Article
tri Empagliflozin as Add-On to Metformin in Patients With Type 2 Diabetes: A 24-Week, Randomized, Double-Blind, Placebo-Controlled Trial By care.diabetesjournals.org Published On :: 2014-06-01 Hans-Ulrich HäringJun 1, 2014; 37:1650-1659Emerging Technologies and Therapeutics Full Article
tri Update on Cardiovascular Outcomes at 30 Years of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study By care.diabetesjournals.org Published On :: 2014-01-01 John M. LachinJan 1, 2014; 37:39-43DCCT/EDIC 30th Anniversary Summary Findings Full Article
tri A Low-Glycemic Load Diet Facilitates Greater Weight Loss in Overweight Adults With High Insulin Secretion but Not in Overweight Adults With Low Insulin Secretion in the CALERIE Trial By care.diabetesjournals.org Published On :: 2005-12-01 Anastassios G. PittasDec 1, 2005; 28:2939-2941BR Clinical Care/Education/Nutrition Full Article
tri New Insulin Glargine 300 Units/mL Versus Glargine 100 Units/mL in People With Type 2 Diabetes Using Basal and Mealtime Insulin: Glucose Control and Hypoglycemia in a 6-Month Randomized Controlled Trial (EDITION 1) By care.diabetesjournals.org Published On :: 2014-10-01 Matthew C. RiddleOct 1, 2014; 37:2755-2762Emerging Technologies and Therapeutics Full Article
tri Rapid Rise in Hypertension and Nephropathy in Youth With Type 2 Diabetes: The TODAY clinical trial By care.diabetesjournals.org Published On :: 2013-06-01 TODAY Study GroupJun 1, 2013; 36:1735-1741TODAY Study Full Article
tri Prevalence of Diabetes in Mexican Americans, Cubans, and Puerto Ricans From the Hispanic Health and Nutrition Examination Survey, 1982-1984 By care.diabetesjournals.org Published On :: 1991-07-01 Katherine M FlegalJul 1, 1991; 14:628-638Supplement 3: Diabetes in Hispanic Americans Full Article
tri Neuropathy and Related Findings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study By care.diabetesjournals.org Published On :: 2014-01-01 Catherine L. MartinJan 1, 2014; 37:31-38DCCT/EDIC 30th Anniversary Summary Findings Full Article
tri Sodium-Glucose Cotransporter 2 Inhibition and Glycemic Control in Type 1 Diabetes: Results of an 8-Week Open-Label Proof-of-Concept Trial By care.diabetesjournals.org Published On :: 2014-05-01 Bruce A. PerkinsMay 1, 2014; 37:1480-1483Novel Communications in Diabetes Full Article
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tri The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview By care.diabetesjournals.org Published On :: 2014-01-01 David M. NathanJan 1, 2014; 37:9-16DCCT/EDIC 30th Anniversary Summary Findings Full Article
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tri Metabolic Implications of Body Fat Distribution By care.diabetesjournals.org Published On :: 1991-12-01 Per BjörntorpDec 1, 1991; 14:1132-1143Diet and Diabetes Full Article
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tri Cardiovascular Outcomes Trials in Type 2 Diabetes: Where Do We Go From Here? Reflections From a Diabetes Care Editors Expert Forum By care.diabetesjournals.org Published On :: 2018-01-01 William T. CefaluJan 1, 2018; 41:14-31Diabetes Care Expert Forum Full Article
