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Liraglutide, a Long-Acting Human Glucagon-Like Peptide-1 Analog, Given as Monotherapy Significantly Improves Glycemic Control and Lowers Body Weight Without Risk of Hypoglycemia in Patients With Type 2 Diabetes

Tina Vilsbøll
Jun 1, 2007; 30:1608-1610
BR Emerging Treatments and Technologies




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Insulinotropic Action of Glucagonlike Peptide-I-(7-37) in Diabetic and Nondiabetic Subjects

David M Nathan
Feb 1, 1992; 15:270-276
Short Report




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Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association

Caroline S. Fox
Sep 1, 2015; 38:1777-1803
Scientific Statement




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Metformin Improves Glucose, Lipid Metabolism, and Reduces Blood Pressure in Hypertensive, Obese Women

Dario Giugliano
Oct 1, 1993; 16:1387-1390
Short Report




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Diabetes Prevention in the Real World: Effectiveness of Pragmatic Lifestyle Interventions for the Prevention of Type 2 Diabetes and of the Impact of Adherence to Guideline Recommendations: A Systematic Review and Meta-analysis

Alison J. Dunkley
Apr 1, 2014; 37:922-933
Current Concepts of Type 2 Diabetes Prevention




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Undiagnosed NIDDM: Clinical and Public Health Issues

Maureen I Harris
Apr 1, 1993; 16:642-652
Kelly West Lecture 1992




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Relationship of Glucose Tolerance and Plasma Insulin to the Incidence of Coronary Heart Disease: Results from Two Population Studies in Finland

Kalevi Pyörälä
Mar 1, 1979; 2:131-141
Proceedings of the Kroc Foundation International Conference on Epidemiology of Diabetes and its Macrovascular Complications




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Coronary Heart Disease Incidence and Cardiovascular Mortality in Busselton with Reference to Glucose and Insulin Concentrations

T A Welborn
Mar 1, 1979; 2:154-160
Proceedings of the Kroc Foundation International Conference on Epidemiology of Diabetes and its Macrovascular Complications




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The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview

David M. Nathan
Jan 1, 2014; 37:9-16
DCCT/EDIC 30th Anniversary Summary Findings




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Impact of Recent Increase in Incidence on Future Diabetes Burden: U.S., 2005-2050

K.M. Venkat Narayan
Sep 1, 2006; 29:2114-2116
BR Epidemiology/Health Services/Psychosocial Research




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Consensus Development Conference on the Diagnosis of Coronary Heart Disease in People With Diabetes: 10-11 February 1998, Miami, Florida

American Diabetes Association
Sep 1, 1998; 21:1551-1559
Consensus Development Conference Report




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U.N. triples coronavirus aid appeal to help most vulnerable countries

The United Nations more than tripled its humanitarian aid appeal on Thursday from $2 billion to $6.7 billion to accommodate its updated global plan to help the poorest nations fight the coronavirus pandemic.




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South Korea sees new cluster of COVID-19 cases tied to nightclubs

Just days after South Korea loosened its social distancing guidelines, a new COVID-19 cluster of infections has sprung up in the capital city of Seoul tied to several nightclubs.




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More than 70 dead in Rwanda after floods, landslides

Heavy rains, flash flooding and landslides have led to the deaths of more than 70 people in Rwanda, officials said Friday.




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Northrop Grumman, Raytheon partner for Next Generation Interceptor bid

Northrop Grumman Corp. and Raytheon Missiles and Defense will partner to develop the Defense Department's next missile interceptor, they announced on Monday.




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DoD releases name of soldier who died in 'non-combat-related' incident in Iraq

The Pentagon announced Tuesday that Sgt. Christopher Wesley Curry died Monday in Iraq in what officials describe as a non-combat-related incident.




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Air Force, Marines train near China amid heightened tensions

The Air Force and Marines have both reported engaging in training maneuvers in the East and South China Sea in recent weeks amid escalating tensions in the region.




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Memo: Prior COVID-19 diagnosis 'permanently disqualifying' for U.S. military service

Military Entrance Processing Stations won't process individuals who have had COVID-19 for military service, even if they've fully recovered from the virus, the Pentagon confirmed this week.




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Blue Angels to fly over Jacksonville, Miami on Friday

The U.S. Navy Flight Demonstration Squadron, the Blue Angels, will fly over Jacksonville and Miami, Fla., Friday as part of a nationwide tour to show appreciation for healthcare workers and frontline responders.




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Diabetes and Aging: Unique Considerations and Goals of Care

Rita R. Kalyani
Apr 1, 2017; 40:440-443
Emerging Science and Concepts for Management of Diabetes and Aging




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Red and Processed Meats and Health Risks: How Strong Is the Evidence?

Frank Qian
Feb 1, 2020; 43:265-271
Perspectives in Care




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Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study

Khalid A. Jadoon
Oct 1, 2016; 39:1777-1786
Emerging Technologies and Therapeutics




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PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes

Vanita R. Aroda
Sep 1, 2019; 42:1724-1732
Emerging Therapies: Drugs and Regimens




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The Pathophysiology of Hyperglycemia in Older Adults: Clinical Considerations

Pearl G. Lee
Apr 1, 2017; 40:444-452
Emerging Science and Concepts for Management of Diabetes and Aging




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Dietary Sugar and Body Weight: Have We Reached a Crisis in the Epidemic of Obesity and Diabetes?: Health Be Damned! Pour on the Sugar

George A. Bray
Apr 1, 2014; 37:950-956
Current Concepts of Type 2 Diabetes Prevention




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The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview

David M. Nathan
Jan 1, 2014; 37:9-16
DCCT/EDIC 30th Anniversary Summary Findings




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SGLT2 Inhibitors and the Diabetic Kidney

Paola Fioretto
Aug 1, 2016; 39:S165-S171
III. SGLT2 Therapy




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Long-Acting Glucagon-Like Peptide 1 Receptor Agonists: A review of their efficacy and tolerability

Alan J. Garber
May 1, 2011; 34:S279-S284
Diabetes Treatments




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Efficacy and Safety of Liraglutide 3.0 mg in Individuals With Overweight or Obesity and Type 2 Diabetes Treated With Basal Insulin: The SCALE Insulin Randomized Controlled Trial

W. Timothy Garvey
May 1, 2020; 43:1085-1093
Emerging Therapies: Drugs and Regimens




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Oral Semaglutide Versus Empagliflozin in Patients With Type 2 Diabetes Uncontrolled on Metformin: The PIONEER 2 Trial

Helena W. Rodbard
Dec 1, 2019; 42:2272-2281
Emerging Therapies: Drugs and Regimens




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Guideline Approach to Therapy in Patients With Newly Diagnosed Type 2 Diabetes

Itamar Raz
Aug 1, 2013; 36:S139-S144
Diabetes Pathophysiology




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Treatment of Type 2 Diabetes: From "Guidelines" to "Position Statements" and Back: Recommendations of the Israel National Diabetes Council

Ofri Mosenzon
Aug 1, 2016; 39:S146-S153
II. Diabetes Treatment Options




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Steroid Metabolomic Signature of Insulin Resistance in Childhood Obesity

OBJECTIVE

On the basis of urinary steroidal gas chromatography-mass spectrometry (GC-MS), we previously defined a novel concept of a disease-specific "steroid metabolomic signature" and reclassified childhood obesity into five groups with distinctive signatures. The objective of the current study was to delineate the steroidal signature of insulin resistance (IR) in obese children.

RESEARCH DESIGN AND METHODS

Urinary samples of 87 children (44 girls) aged 8.5–17.9 years with obesity (BMI >97th percentile) were quantified for 31 steroid metabolites by GC-MS. Defined as HOMA-IR >95th percentile and fasting glucose-to-insulin ratio >0.3, IR was diagnosed in 20 (of 87 [23%]) of the examined patients. The steroidal fingerprints of subjects with IR were compared with those of obese children without IR (non-IR). The steroidal signature of IR was created from the product of IR – non-IR for each of the 31 steroids.

RESULTS

IR and non-IR groups of children had comparable mean age (13.7 ± 1.9 and 14.6 ± 2.4 years, respectively) and z score BMI (2.7 ± 0.5 and 2.7 ± 0.5, respectively). The steroidal signature of IR was characterized by high adrenal androgens, glucocorticoids, and mineralocorticoid metabolites; higher 5α-reductase (An/Et) (P = 0.007) and 21-hydroxylase [(THE + THF + αTHF)/PT] activity (P = 0.006); and lower 11βHSD1 [(THF + αTHF)/THE] activity (P = 0.012).

CONCLUSIONS

The steroidal metabolomic signature of IR in obese children is characterized by enhanced secretion of steroids from all three adrenal pathways. As only the fasciculata and reticularis are stimulated by ACTH, these findings suggest that IR directly affects the adrenals. We suggest a vicious cycle model, whereby glucocorticoids induce IR, which could further stimulate steroidogenesis, even directly. We do not know whether obese children with IR and the new signature may benefit from amelioration of their hyperadrenalism.




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Redefining Hypoglycemia in Clinical Trials: Validation of Definitions Recently Adopted by the American Diabetes Association/European Association for the Study of Diabetes

OBJECTIVE

To determine if the International Hypoglycaemia Study Group (IHSG) level 2 low glucose definition can identify clinically relevant hypoglycemia in clinical trials and offer value as an end point for future trials.

RESEARCH DESIGN AND METHODS

A post hoc analysis was performed of the SWITCH (SWITCH 1: n = 501, type 1 diabetes; SWITCH 2: n = 721, type 2 diabetes) and DEVOTE (n = 7,637, type 2 diabetes) trials utilizing the IHSG low glucose definitions. Patients in all trials were randomized to either insulin degludec or insulin glargine 100 units/mL. In the main analysis, the following definitions were compared: 1) American Diabetes Association (ADA) 2005 (plasma glucose [PG] confirmed ≤3.9 mmol/L with symptoms); and 2) IHSG level 2 (PG confirmed <3.0 mmol/L, independent of symptoms).

RESULTS

In SWITCH 2, the estimated rate ratios of hypoglycemic events indicated increasing differences between treatments with decreasing PG levels until 3.0 mmol/L, following which no additional treatment differences were observed. Similar results were observed for the SWITCH 1 trial. In SWITCH 2, the IHSG level 2 definition produced a rate ratio that was lower than the ADA 2005 definition.

CONCLUSIONS

The IHSG level 2 definition was validated in a series of clinical trials, demonstrating its ability to discriminate between basal insulins. This definition is therefore recommended to be uniformly adopted by regulatory bodies and used in future clinical trials.




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Vasodilatory Actions of Glucagon-Like Peptide 1 Are Preserved in Skeletal and Cardiac Muscle Microvasculature but Not in Conduit Artery in Obese Humans With Vascular Insulin Resistance

OBJECTIVE

Obesity is associated with microvascular insulin resistance, which is characterized by impaired insulin-mediated microvascular recruitment. Glucagon-like peptide 1 (GLP-1) recruits skeletal and cardiac muscle microvasculature, and this action is preserved in insulin-resistant rodents. We aimed to examine whether GLP-1 recruits microvasculature and improves the action of insulin in obese humans.

RESEARCH DESIGN AND METHODS

Fifteen obese adults received intravenous infusion of either saline or GLP-1 (1.2 pmol/kg/min) for 150 min with or without a euglycemic insulin clamp (1 mU/kg/min) superimposed over the last 120 min. Skeletal and cardiac muscle microvascular blood volume (MBV), flow velocity and blood flow, brachial artery diameter and blood flow, and pulse wave velocity (PWV) were determined.

RESULTS

Insulin failed to change MBV or flow in either skeletal or cardiac muscle, confirming the presence of microvascular insulin resistance. GLP-1 infusion alone increased MBV by ~30% and ~40% in skeletal and cardiac muscle, respectively, with no change in flow velocity, leading to a significant increase in microvascular blood flow in both skeletal and cardiac muscle. Superimposition of insulin to GLP-1 infusion did not further increase MBV or flow in either skeletal or cardiac muscle but raised the steady-state glucose infusion rate by ~20%. Insulin, GLP-1, and GLP-1 + insulin infusion did not alter brachial artery diameter and blood flow or PWV. The vasodilatory actions of GLP-1 are preserved in both skeletal and cardiac muscle microvasculature, which may contribute to improving metabolic insulin responses and cardiovascular outcomes.

CONCLUSIONS

In obese humans with microvascular insulin resistance, GLP-1’s vasodilatory actions are preserved in both skeletal and cardiac muscle microvasculature, which may contribute to improving metabolic insulin responses and cardiovascular outcomes.




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Association of Urine Haptoglobin With Risk of All-Cause and Cause-Specific Mortality in Individuals With Type 2 Diabetes: A Transethnic Collaborative Work

OBJECTIVE

Haptoglobin is an acute-phase reactant with pleiotropic functions. We aimed to study whether urine haptoglobin may predict risk of mortality in people with type 2 diabetes.

RESEARCH DESIGN AND METHODS

We employed a transethnic approach with a cohort of Asian origin (Singapore) (N = 2,061) and a cohort of European origin (France) (N = 1,438) included in the study. We used survival analyses to study the association of urine haptoglobin with risk of all-cause and cause-specific mortality.

RESULTS

A total of 365 and 525 deaths were registered in the Singapore cohort (median follow-up 7.5 years [interquartile range 3.5–12.8]) and French SURDIAGENE cohort (median follow-up 6.8 years [interquartile range 4.3–10.5], respectively. Singapore participants with urine haptoglobin in quartiles 2 to 4 had higher risk for all-cause mortality compared with quartile 1 (unadjusted hazard ratio [HR] 1.47 [95% CI 1.02–2.11], 2.28 [1.62–3.21], and 4.64 [3.39–6.35], respectively). The association remained significant in quartile 4 after multiple adjustments (1.68 [1.15–2.45]). Similarly, participants in the French cohort with haptoglobin in quartile 4 had significantly higher hazards for all-cause mortality compared with quartile 1 (unadjusted HR 2.67 [2.09–3.42] and adjusted HR 1.49 [1.14–1.96]). In both cohorts, participants in quartile 4 had a higher risk of mortality attributable to cardiovascular disease and infection but not malignant tumor.

CONCLUSIONS

Urine haptoglobin predicts risk of mortality independent of traditional risk factors, suggesting that it may potentially be a novel biomarker for risk of mortality in patients with type 2 diabetes.




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Leukocyte Telomere Length, DNA Oxidation, and Risk of Lower-Extremity Amputation in Patients With Long-standing Type 1 Diabetes

OBJECTIVE

Telomere shortening and DNA oxidation are associated with premature vascular aging, which may be involved in lower-extremity amputation (LEA). We sought to investigate whether leukocyte telomere length (LTL) and plasma 8-hydroxy-2'-deoxyguanosine (8-OHdG), a biomarker of DNA oxidation, were associated with LEA in subjects with type 1 diabetes at high vascular risk.

RESEARCH DESIGN AND METHODS

LTL (quantitative PCR) and plasma 8-OHdG concentrations (immunoassay method) were assessed at baseline in the GENEDIAB (Génétique de la Néphropathie Diabétique) type 1 diabetes cohort. Logistic and Cox proportional hazards regression models were fitted to estimate odds ratio (OR) (at baseline) and hazard ratio (HR) (during follow-up), with related 95% CI, by increasing biomarker tertiles (T1, T2, T3).

RESULTS

Among 478 participants (56% male, mean ± SD age 45 ± 12 years and diabetes duration 29 ± 10 years), 84 patients had LEA at baseline. Baseline history of LEA was associated with shorter LTL (OR for T2 vs. T1 0.62 [95% CI 0.32–1.22] and for T3 vs. T1 0.41 [0.20–0.84]) but not with plasma 8-OHdG (1.16 [0.56–2.39] and 1.24 [0.61–2.55], respectively). New cases of LEA occurred in 34 (12.3%) participants during the 10-year follow-up. LTL were shorter (HR T2 vs. T1 0.25 [95% CI 0.08–0.67] and T3 vs. T1 0.29 [0.10–0.77]) and plasma 8-OHdG higher (2.20 [0.76–7.35] and 3.11 [1.07–10.32]) in participants who developed LEA during follow-up compared with others. No significant interaction was observed between biomarkers on their association with LEA.

CONCLUSIONS

We report the first independent association between LTL shortening and excess risk of LEA in type 1 diabetes. High plasma 8-OHdG was also associated with incident LEA but partly dependent on cofounding variables.




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Inmigrantes centroamericanos en los Estados Unidos

Si bien se ha prestado mucha atención a los centroamericanos recién llegados a la frontera entre los Estados Unidos y México, casi la mitad de los aproximadamente 3.5 millones que vivían en los Estados Unidos en 2017 llegaron antes de 2000. Aproximadamente un tercio son ciudadanos estadounidenses y tienden a participar en la fuerza laboral con más frecuencia que otros extranjeros y estadounidenses. Descubra más en este artículo lleno de datos.




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Amid an Unfolding Humanitarian Crisis in Syria, the European Union Faces the Perils of Devolving Migration Management to Turkey

The high-stakes gambit taken by Turkish President Recep Tayyip Erdoğan to allow tens of thousands of asylum seekers and migrants free movement to the Greek border demonstrated the fragility of the EU-Turkey deal and the European Union's broader approach to outsource migration management to third countries. This article examines the causes for the tensions, the EU approach to external partnerships, and a hardening European attitude towards unwanted arrivals.




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As COVID-19 Slows Human Mobility, Can the Global Compact for Migration Meet the Test for a Changed Era?

The coronavirus pandemic dramatically reshaped how human mobility is managed just as the Global Compact for Safe, Orderly, and Regular Migration was beginning to move from paper to implementation. As governments face pressing public-health, economic, and other concerns in responding to COVID-19, this MPI Europe commentary explores whether the first comprehensive global agreement on migration can adjust to a changed reality.




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Invertir en el Vecindario: Cambios en los Patrones de Migración Entre México y Estados Unidos y Oportunidades para una Cooperación Sostenible

Presentación del reporte que refleja el contenido de encuentros del grupo de estudio sobre la migración México-Estados Unidos convocado por El Colegio de México y el Migration Policy Institute (MPI).




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Soluciones estratégicas para afrontar la crisis migratoria en Estados Unidos y México

Dado el incremento de los flujos migratorios provenientes de Centroamérica, el pasado mes de junio de 2019, los Estados Unidos y México acordaron tomar una serie de medidas para reducir los flujos irregulares. Sin embargo, será muy difícil mantener estos esfuerzos de corto plazo, debido a una debilidad institucional crónica y a estructuras de política pública poco planificadas en ambos países. Este comentario ofrece cinco recomendaciones a ambos países considerando soluciones de mediano y largo plazo para disuadir la migración irregular y, al mismo tiempo, garantizar que aquellos que busquen protección tengan un proceso justo.




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HHS releases video tutorial for searching list of excluded individuals/entities

The Department of Health and Human Services released Nov. 25 a five-minute video explaining how to search its list of excluded individuals and entities, called LEIE.




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Former ADA vice president dies at 87

Dr. Chauncey Cross, who served as vice president of the American Dental Association from 1997-98, died Sept. 5, 2019, on his 87th birthday.




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Anniversary of community water fluoridation arrives

The ADA National Fluoridation Advisory Committee is inviting dentists and others who promote the adoption and continuation of adding an optimal amount of fluoride to water to celebrate this year.




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From high school student to dentist, Give Kids A Smile volunteer continues commitment

Dr. Theressa Eliscar-Hewett began volunteering at the Nassau County Give Kids A Smile event in Long Island, New York, as a high school student. More than 10 years later, she continues to volunteer, only now as a dentist.




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Arizona Mission of Mercy event provides treatment to over 1,700

The Central Arizona Dental Society hosted a Mission of Mercy event Dec. 13-14 at the Arizona State Fairgrounds in Phoenix, providing treatment to 1,785 patients totaling just over $2 million in free dental service.




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Send Give Kids A Smile photos

ADA News welcomes digital submissions from GKAS program participants.




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Tufts University program provides homeless veterans with advanced dental care

Service With A Smile was among 10 programs from nine universities to receive funding this year through the ADA Foundation’s E. “Bud” Tarrson Dental School Student Community Leadership Awards.




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National Children’s Dental Health Month highlights optimally fluoridated water

This year the February observance of National Children’s Dental Health Month honors the 75th anniversary of community water fluoridation with its theme, “Fluoride in water prevents cavities! Get it from the tap!”