Does the short-term use of continuous glucose monitoring enhance diabetes self-management behaviour in type 2 diabetes? The DISCO GM Study: A randomised, controlled cross-over study.

Introduction: There is little evidence on the impact of Continuous Glucose Monitoring (CGM) on self-management behaviour in people with type 2 diabetes using participant reported outcome measures. We aimed to assess whether self-management behaviour, measured by the Diabetes Self-Management Questionnaire (DSMQ), is altered by the short-term use of CGM in people with complex type 2 diabetes.

Methods: Open, single-centre, randomised crossover study lasting 36 weeks.

Reversible coagulopathy associated with vitamin E excess.

Vitamin E refers to a group of compounds that are essential to the diet of animals, where its primary function is an antioxidant. Excessive vitamin E supplementation can cause a reversible coagulopathy in the setting of compromised vitamin K absorption or function. We describe the case of a woman in her mid-80s treated for micronutrient deficiencies following a biliopancreatic diversion as a bariatric procedure 14 years previously.

The Use of Non-i nvasive Biomarkers to Screen for Advanced Fibrosis Associated with Metabolic Dysfunction-associated Steatotic Liver Disease in People with Type 2 Diabetes: A Narrative Review.

There is growing interest in metabolic dysfunction-associated steatotic liver disease (MASLD), given its increasing prevalence and our developing understanding of the disease. People living with type 2 diabetes or obesity have a greater risk of developing significant hepatic steatosis and a greater risk of more rapid progression to steatohepatitis, advanced hepatic fibrosis and hepatocellular carcinoma. As such, various international bodies now advocate for routine screening for MASLD-related hepatic fibrosis in people with such risk factors.

Assessing glycaemic impact of FreeStyle libre monitoring in patients with insulin-treated type 2 diabetes: a retrospective real-world analysis.

Objectives: FreeStyle Libre (FSL) monitoring is available for all patients in Wales with insulin-treated diabetes. English guidance permits FSL in patients with type 1 diabetes mellitus (T1D) and type 2 diabetes mellitus (T2D) requiring multiple daily insulin doses (MDI) (National Institute for Health and Care Excellence 2023). The literature suggests benefits from using FSL, specifically improved glycaemic control and reduced hypoglycaemia.

The Bidirectional Relationship Between Type 2 Diabetes and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Retrospective Cohort Study.

Introduction Type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) have shared pathophysiology. We aim to explore associations between these diseases and the impact of T2D therapies on MASLD-related outcomes in a real-world population. Methods A retrospective cohort study included 153 patients with biopsy-proven MASLD.

Changes in Cognitive Function Following Bariatric Surgery: An Updated Systematic Review.

Since a previous systematic review published in 2016, there have been further studies investigating the association of changes in cognitive function following bariatric surgery. All studies since the original review that reported at least one element of cognitive function before and after bariatric surgery were eligible. A total of 137 additional studies were identified; 13 were included in addition to the 18 studies previously.

The effect of sodium-glucose cotransporter-2 inhibitors on inflammatory biomarkers: A meta-analysis of randomized controlled trials.

Aims: To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers.

Methods: Medline, Embase and the Cochrane Library were searched for RCTs investigating the effect of SGLT2 inhibitors on inflammatory biomarkers, adipokine profiles and insulin sensitivity.

Results: Thirty-eight RCTs were included (14 967 participants, 63.

Benefits in routinely measured liver function tests following bariatric surgery: a retrospective cohort study.

Background: Bariatric surgery is well-established to support long-term metabolic health benefits associated with considerable weight loss. Here, we aim to determine the longer-term impact of bariatric surgery on liver enzymes and associations with other metabolic improvements.

Methods: One hundred patients who underwent bariatric surgery between 2007 and 2014 were included, and changes in liver enzymes, anthropometric measures and other parameters were observed over a mean 9.

Diabetes management in older adults who fall: a study amongst older adults presenting to the emergency department.

Introduction: Type 2 diabetes mellitus (T2D) is associated with poor health outcomes whilst tight glycaemic targets are questionable in those aged over 70 years with increased frailty. Our aim was to examine whether people with T2D admitted to hospital with a fall, were more likely to have greater frailty, increased mortality and co-morbidity burden, or risk factors for falls than people without T2D, and whether these differences were associated with medications used for the treatment of T2D.

Methods: The Older Persons Assessment Service (OPAS) is a local emergency department (ED) service, which accepts patients on frailty criteria.

Natural history of pituitary apoplexy: a long-term follow-up study.

Background And Aims: Pituitary apoplexy (PA) is a rare neurosurgical emergency, associated with deficiency of one or more pituitary hormones. Few studies have explored the relative outcomes associated with conservative and neurosurgical intervention.

Methods: A retrospective evaluation of all patients with PA reviewed at Morriston Hospital was undertaken and diagnosis was obtained from Morriston database (Leicester Clinical Workstation database) between 1998 and 2019 from clinic letters and discharge summaries.

Achievement of the ESC recommendations for secondary prevention of cardiovascular risk factors in high-risk patients with type 2 diabetes: A real-world national cohort analysis.

Aim: To assess compliance with European Society of Cardiology (ESC) secondary prevention recommendations in a nationwide contemporary population with diabetes mellitus (DM) and coronary artery disease.

Method: We conducted a retrospective observational study using linked health data in patients across Wales with DM undergoing percutaneous coronary intervention (2012-2017). The follow-up was for one year.

A series of diabetic ketoacidosis associated with the use of sodium-glucose co-transporter-2 inhibitors in secondary care.

Background And Aims: Sodium-glucose co-transporter-2 inhibitors (SGLT-2i) are associated with diabetic ketoacidosis (DKA), however limited case series are published.

Methods: We evaluated the characteristics of patients admitted with SGLT-2i associated DKA.

Results: Over 4 months, 22 patients were identified; 45.

Diabetes mellitus: what the neurologists need to know.

Diabetes mellitus is a common condition associated with numerous complications and comorbidities. The diabetes spectrum includes type 1, type 2 and other forms of diabetes, which may be associated with medical therapies and genetic factors. Type 2 diabetes is managed with lifestyle, oral therapies, non-insulin-based injectables and subsequently insulin.

Personalized Type 2 Diabetes Management: An Update on Recent Advances and Recommendations.

Previous guidelines for the treatment of people with type 2 diabetes mellitus (T2D) have relied heavily upon rigid algorithms for the sequential addition of pharmacotherapies to achieve target glycemic control. More recent guidelines advocate a personalized approach for diabetes treatment, to improve patient satisfaction, quality of life, medication adherence and overall health outcomes. Clinicians should work with patients to develop personalized goals for their treatment, including targeted glycemic control, weight management, prevention and treatment of associated comorbidities and avoidance of complications such as hypoglycemia.

Glucagon-like peptide-1 receptor agonists improve biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomised controlled trials.

Aim: To conduct a meta-analysis and systematic review to examine the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on clinical biomarkers of inflammation and oxidative stress in patients with type 2 diabetes.

Methods: Medline, Embase and the Cochrane Library were searched for randomised controlled trials (RCTs) that examined changes with GLP-1RAs in a priori selected biomarkers of inflammation: C-reactive protein (CRP), adiponectin, tumour necrosis factor-alpha (TNFα), plasminogen activator inhibitor-1, interleukin-6, leptin; and of oxidative stress: malondialdehyde (MDA); 8-iso-prostaglandin F2α; and 8-hydroxy-2'-deoxyguanosine (8-OHdG).

Results: We included 40 eligible RCTs (n = 6749) with a median follow-up of 6 months, a mean participant age of 53.

Real-World Clinical Experience of Semaglutide in Secondary Care Diabetes: A Retrospective Observational Study.

Introduction: The glucagon-like peptide-1 receptor analogue (GLP-1RA) semaglutide is associated with improvements in glycaemia and cardiovascular risk factors in clinical trials. The aim of this study was to examine the real-world impact of semaglutide administered by injection in people with type 2 diabetes (T2D) across three secondary care sites in Wales.

Methods: A retrospective evaluation of 189 patients with T2D initiated on semaglutide between January 2019 and June 2020 with at least one follow-up visit was undertaken.

A systematic review examining the effects of sodium-glucose cotransporter-2 inhibitors (SGLT2is) on biomarkers of inflammation and oxidative stress.

Aims: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have a protective cardiorenal effect in type 2 diabetes. This systematic review examines the effects of SGLT2is on clinical biomarkers of inflammation and oxidative stress.

Methods: A search of Medline, Embase, Web of Science, and The Cochrane Library was performed examining changes in selected clinical biomarkers for inflammation: c-reactive protein (CRP), adiponectin, interleukin-6 (IL6), tumour necrosis factor-alpha (TNF-α), and oxidative stress: 8-iso-prostaglandin F2α (8-iso-PGF2α) and 8-hydroxy-2'-deoxyguanosine (8-OHdG).

Chronic kidney disease in type 2 diabetes: Implications for managing glycaemic control, cardiovascular and renal risk.

This review examines the current literature relating to diabetes related kidney disease (DKD) and the optimal management of cardio-renal risk. DKD develops in approximately 40% of patients with type 2 diabetes mellitus. The mainstay of therapy is to reduce the progression of DKD by optimising hyperglycaemia, blood pressure, lipids and lifestyle.

Dapagliflozin is associated with improved glycaemic control and weight reduction at 44 months of follow-up in a secondary care diabetes clinic in the UK.

Background And Aims: We examined HbA1c and cardiovascular risk factors with a median follow-up of 44 months therapy with dapagliflozin.

Methods: We undertook a clinical practice evaluation of 101 patients attending our clinic.

Results: Dapagliflozin resulted in a significant reduction in HbA1c 82.

The impact of structured self-monitoring of blood glucose on glycaemic variability in non-insulin treated type 2 diabetes: The SMBG study, a 12-month randomised controlled trial.

Background And Aims: There is inconsistent evidence supporting the self-monitoring of blood glucose (SMBG) in people with non-insulin treated type 2 diabetes (T2D). Structured SMBG protocols have a greater impact on glycaemic control than unstructured SMBG and may improve measures of glycaemic variability (GV), though few previous studies have reported on specific GV outcomes. Our aim was to determine the impact of structured SMBG on simple measures of GV in people with T2D.