Diabetic medicine : a journal of the British Diabetic Association
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Comparative Study
Unexpectedly long half-life of metformin elimination in cases of metformin accumulation.
In a study of the oral administration of a single dose of metformin to healthy participants, the estimated half-life (t½ ) for the elimination of the drug from erythrocytes was found to be 23.4 h (compared with 2.7 h for metformin in plasma). However, these pharmacokinetic indices have not been well defined in metformin accumulation. ⋯ The prolonged elimination of accumulated metformin (even after dialysis therapy) challenges the traditional view that the drug clears rapidly because of a short half-life in plasma.
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Controlled Clinical Trial
Measurement of small fibre pain threshold values for the early detection of diabetic polyneuropathy.
To investigate whether Aδ and C fibre pain threshold values, measured using intra-epidermal electrical stimulation (IES), in people with and without Type 2 diabetes are useful in evaluating diabetic polyneuropathy (DPN) severity. ⋯ Intra-epidermal electrical stimulation is a non-invasive and easy measurement of small fibre pain threshold values. It may be clinically useful for C fibre measurement to diagnose early DPN as defined by the Diabetic Neuropathy Study Group in Japan criteria.
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To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade. ⋯ A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high-quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop.
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Observational Study
Metabolic syndrome of weight change from pre-pregnancy to 1-5 years post-partum among Chinese women with prior gestational diabetes.
Few studies have evaluated the effect of weight change from pre-pregnancy to post-partum with the risk of cardiometabolic diseases among women with a history of gestational diabetes mellitus. The aim of this study was to evaluate the association between weight change from pre-pregnancy to 1-5 years post-partum with metabolic syndrome among Chinese women with prior gestational diabetes mellitus. ⋯ Women with gestational diabetes mellitus who had large weight gain from pre-pregnancy to post-partum were more likely to develop metabolic syndrome. Women who are pre-pregnancy overweight/obesity and also diagnosed as gestational diabetes mellitus during pregnancy need more weight control after delivery.
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Comparative Study Observational Study
Cardiovascular risks associated with second-line oral antidiabetic agents added to metformin in patients with Type 2 diabetes: a nationwide cohort study.
To compare the cardiovascular risks associated with second-line oral antidiabetic agents added to initial metformin therapy in a large nationwide observational study. ⋯ There were no differences in overall cardiovascular risks among several add-on second-line oral antidiabetic agents; however, glinide plus metformin and α-glucosidase inhibitors plus metformin combination therapies might be associated with lower risks of acute myocardial infarction.