Prescription distribution and inequities in diabetes care: A comparative analysis of continuous glucose monitoring access by diabetes status, ethnicity and socio-economic factors in England.

Background: Diabetes affects over 3.3 million people in England, creating a significant health and economic burden. Continuous glucose monitoring (CGM) improves diabetes management but remains unevenly accessible, especially among Black and minority groups who face onset at younger ages, higher diabetes rates and complications.

Trends in mortality and hospitalisations for cardiovascular, kidney and liver disease in people with type 2 diabetes in England, 2009-2019.

Aims: To assess longitudinal trends in total and cause-specific mortality rates and in hospitalisation rates for diabetes complications among people with type 2 diabetes in England between 2009 and 2019; and to assess how trends differ by patient characteristics.

Materials And Methods: A sequential cohort study of people with type 2 diabetes aged ≥20 years was performed using data from the National Diabetes Audit. Discretised Poisson regression models, adjusted for age, sex, ethnicity, socio-economic deprivation and diabetes duration, were used to calculate total and cause-specific mortality rates, as well as hospitalisation rates for myocardial infarction, stroke, heart failure, kidney and liver disease.

Maternal ethnic group, socioeconomic status, and neonatal and child mortality: a nationwide cohort study in England and Wales.

Background: The UK currently has one of the highest rates of child mortality in Europe. Robust population-level estimates of differences in neonatal and child mortality by ethnic and socioeconomic group are currently scarce for England and Wales. We aimed to examine variation in neonatal and child mortality by maternal ethnic group and indicators of socioeconomic status to help understand which groups are most at risk of neonatal and child mortality.

The Healthcare Professionals Attitudes Towards Deprescribing (HATD) tool in older persons with multiple long-term chronic conditions and those on palliative care: A mixed methods study.

Objectives: To investigate healthcare professionals' (HCPs) perspectives towards deprescribing in older adults living with multiple long term conditions (MLTCs), including those at the end of life, using the validated Healthcare Professionals' Attitudes Towards Deprescribing (HATD) tool, and to explore implications for medication management in conditions such as diabetes, where polypharmacy is common.

Method: A cross-sectional online survey using the HATD questionnaire was disseminated across the United Kingdom from November 2023 to January 2024. Eligible participants were HCPs with experience managing older adults with MLTCs and/or those receiving end of life care.

Intensity modifies the association between continuous bouts of physical activity and risk of mortality: A prospective UK Biobank cohort analysis.

Background: Recent evidence suggests continuous bouts of physical activity (PA) are associated with longevity. We hypothesized the risk of mortality would be lower when the most active minutes of the day were in a continuous bout.

Methods: PA was assessed using accelerometery in UK Biobank participants.

Long-term effectiveness of iGlarLixi treatment in people with type 2 diabetes in the United States: The soli-durability 24-month observational study.

Aim: To evaluate the effectiveness and safety of a fixed-ratio combination of insulin glargine 100 U/mL and lixisenatide (iGlarLixi) over 24 months in people with type 2 diabetes (T2D).

Methods: In this retrospective, observational study, data were collected from the Optum Market Clarity® database in the United States. People with T2D aged ≥18 years, previously treated with oral antidiabetic drugs ± basal insulin or glucagon-like peptide-1 receptor agonists, who initiated iGlarLixi between 1 January 2017 and 31 March 2020 and received ≥1 iGlarLixi prescription were included.

The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes.

Unlabelled: Individuals with Type 2 Diabetes (T2D) are at high risk of subclinical cardiovascular disease (CVD), potentially detectable through retinal alterations. In this single-centre, prospective cohort study, 255 asymptomatic adults with T2D and no prior history of CVD underwent echocardiography, non-contrast coronary computed tomography and cardiovascular magnetic resonance. Retinal photographs were evaluated for diabetic retinopathy grade and microvascular geometric characteristics using deep learning (DL) tools.

The impact of socio-economic deprivation on the long-term survival of people with diabetes and acute myocardial infarction: A nationwide cohort study.

Background: People from areas of socio-economic deprivation have poorer outcomes following acute myocardial infarction (AMI). How deprivation influences the survival of people with diabetes mellitus (DM) post-AMI is not well described.

Methods: Using the Myocardial Ischaemia National Audit Project (MINAP) registry, with Office for National Statistics (ONS) mortality recording, 729,722 patients from England and Wales between 2005 and 2019 were included, 152,867 with DM and followed up to 31 July 2021.

Risk of Ischaemic and Non-Ischaemic Heart Failure in People With Type 2 Diabetes: Observational Study in 1.6 Million People in England.

Aims/hypothesis: Recent evidence shows decreasing trends for ischaemic heart disease over time in the general population as well as in those with type 2 diabetes. As type 2 diabetes has been associated with an increased risk of both ischaemic and non-ischaemic heart failure, a greater proportion of people with type 2 diabetes could now be presenting with non-ischaemic heart failure phenotypes. We aimed to investigate the risk of incident ischaemic and non-ischaemic heart failure in people with type 2 diabetes.

Type 2 diabetes risk communication following a diagnosis of gestational diabetes mellitus: A qualitative study.

Background: Gestational diabetes mellitus (GDM) increases women's risk of developing type 2 diabetes (T2DM) tenfold. Understanding of T2DM risk in women with GDM is variable and can impact health behaviours. To better understand how T2DM risk is communicated by healthcare professionals, we explored women's experiences of T2DM risk communication and support following a diagnosis of GDM.

Psychometric evaluation of the Adelphi Adherence Questionnaire (ADAQ©) in a type 2 diabetes mellitus population as a new measure of adherence and the complex factors influencing adherence in routine care.

Aims: To evaluate the psychometric properties of the Adelphi Adherence Questionnaire (ADAQ©) as an adherence measure in a diverse type 2 diabetes mellitus (T2DM) population in routine clinical practice.

Materials And Methods: Data were drawn from the Adelphi T2DM Disease Specific Programme™, a survey of physicians and adults with T2DM consulting in the United States, February-May 2021. Participants completed the ADAQ and single questions on medication satisfaction and convenience.

Prevalence and patterns of multiple long-term conditions among lymphatic filariasis patients in Odisha, India: a community-based cross-sectional study.

Introduction: Neglected tropical diseases (NTDs), such as lymphatic filariasis, mimic other chronic conditions and share common risk behaviors with parallel health system issues that require unique interventions. Multiple long-term conditions (MLTCs or multimorbidity), defined as two or more chronic conditions has become increasingly common in low- and middle-income countries (LMICs) such as India. However, data on the prevalence of the interface between NTDs and other chronic conditions are lacking.

International expert consensus on surgery for type 2 diabetes mellitus.

Introduction: Metabolic and bariatric surgery (MBS) has been an established treatment option for patients with Type 2 diabetes mellitus (T2DM), but there is a relative paucity of evidence-based guidelines on preoperative, operative, and postoperative considerations concerning metabolic surgery for T2DM patients. To address this gap, we initiated a Delphi consensus process with a diverse group of international multidisciplinary experts.

Method: We embarked on a Delphi consensus-building exercise to propose an evidence-based expert consensus covering various aspects of MBS in patients with T2DM.

Ethnic disparities in COVID-19 mortality and cardiovascular disease in England and Wales between 2020-2022.

An increased risk of COVID-19 mortality risk among certain ethnic groups is well-reported, however data on ethnic disparities in COVID-19-related cardiovascular disease (CVD)  are lacking. We estimated age-standardised incidence rates and adjusted hazard ratios for 28-day mortality and 30-day CVD by sex for individual ethnicity groups from England and Wales, using linked health and administrative data. We studied 6-level census-based ethnicity group classification, 10-level classification (only for Wales), and 19-level classification as well as any ethnicity sub-groups comprising >1000 individuals each (only for England).

Randomised controlled trials for improving health outcomes for people living with multiple long-term conditions: Protocol for a systematic review of methodological approaches, risk of bias and reporting quality.

Introduction: The number of people living with multiple long-term conditions (MLTC or multimorbidity) is increasing. There have been national and international calls for more and better research in this clinical area. This systematic review will assess the methodological approaches, risk of bias and standards of reporting of the included trials.

Managing early-onset type 2 diabetes in the individual and at the population level.

Early-onset type 2 diabetes (defined as type 2 diabetes diagnosed in people aged <40 years) is an increasingly prevalent condition with a more aggressive disease trajectory than late-onset type 2 diabetes. It is associated with accelerated microvascular and macrovascular complications, reduced life expectancy, and adverse pregnancy outcomes. Despite its rising incidence, global management strategies have mostly been extrapolated from studies in older adults with limited evidence specific to younger populations.

Risk factors for development of diabetic foot ulcer disease in two large contemporary UK cohorts.

Aims: Diabetic foot ulcer disease (DFUD) is common, life-changing and associated with a lower 5-Year survival rate than many cancers. However, the risk factors for DFUD have generally been identified in small, single-centre, clinic-based studies, many of which are cross-sectional. This study aims to assess the incidence of DFUD and its related risk factors in two large, contemporary UK cohorts.

Re-evaluating the concept of remission in type 2 diabetes: a call for patient-centric approaches.

Controlling weight and cardiovascular risk factors is paramount in type 2 diabetes management; however, the definition and feasibility of remission warrant closer examination. Type 2 diabetes remission, typically attained through weight loss, appears to be a temporary state based on the 2021 consensus definition, with most individuals experiencing weight regain and relapse of the condition. Although sustained type 2 diabetes remission is possible for some individuals and is associated with improved quality of life and reduced risk for microvascular and macrovascular complications, no conclusive evidence exists to show that achieving normoglycaemia and substantial weight loss without glucose-lowering medications is more beneficial than with them.

Glucose Control, Sulfonylureas, and Insulin Treatment in Older Adults With Type 2 Diabetes and Risk of Falls and Fractures: An Observational Study.

Objective: To estimate the association among glucose control, sulfonylureas, and insulin treatment with the risk of hospitalization for falls and fractures in older adults with type 2 diabetes (T2D).

Research Design And Methods: This observational cohort study used U.K.

SARS-CoV-2 infection and new-onset type 1 diabetes in the post-acute period among children and young people in England.

Aims: To examine if SARS-CoV-2 infection is associated with new-onset type 1 diabetes in the post-acute period in children and young people (CYP).

Methods: In this population cohort, we used data on all hospital activity in England to estimate type 1 diabetes incidence among CYP aged 0-17 exposed to SARS-CoV-2 between May 2020 and August 2022, from day 28 after a positive test for the following 6 months. We compared this with unexposed CYP who were hospitalized for elective procedures or following trauma during the pandemic, and in the 2 years prior to the pandemic (historic cohorts).

Use of sodium valproate and other antiseizure drug treatments in England and Wales: quantitative analysis of nationwide linked electronic health records.

Objective: To investigate the use of sodium valproate in England and Wales, including during pregnancy, compared with other antiseizure drug treatments, based on national level electronic health records.

Design: Quantitative analysis of nationwide linked electronic health records.

Setting: Individual level, population scale data from NHS England's Secure Data Environment, from the British Heart Foundation Data Science Centre's CVD-COVID-UK/COVID-IMPACT Consortium (for England), and the Secure Anonymised Information Linkage Databank (for Wales), 1 January 2019 to 31 December 2023.

The use of SGLT2 inhibitors in people with diabetes-related foot disease: A Delphi-based consensus study.

Aims: To generate expert consensus-based clinical recommendations on the use of SGLT2 inhibitors in those with diabetes and diabetes-related foot disease (DFD).

Materials And Methods: This study employed a two-round online Delphi technique. Participants were healthcare practitioners from a range of relevant clinical backgrounds, recruited using convenience sampling.