Association of Glucagon-Like Peptide-1 Receptor Agonists With Cancer Risk in Older Adults With Type 2 Diabetes.

Objective: The real-world evidence on the association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and cancer risk remains limited and mixed.

Methods: In 2013-2020 national Medicare claims data, we included cancer-naïve patients with type 2 diabetes (T2D). We identified those who initiated GLP-1 RA, sodium-glucose cotransporter 2 inhibitor (SGLT2i), or dipeptidyl peptidase 4 inhibitor (DPP4i) and conducted 1:1 propensity score matching for confounding adjustment.

Cancer beliefs, risk perceptions, and health protective behaviors among people living with diabetes in the United States: Results from the Health Information National Trends Survey.

Objective: Diabetes and cancer share common preventable risk factors, including obesity, physical inactivity, and poor diet. People with diabetes have an increased risk of developing cancer. The objective of our study was to compare cancer risk perceptions, beliefs about cancer, and cancer protective behaviors among people with and without diabetes in the United States.

Lipid-Lowering Medication Management in American Indians with Type 2 Diabetes: A Multi-Year View from a Rural Tribal Health System.

Background: American Indian Peoples have the highest prevalence of diabetes among all racial and ethnic groups. Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in people with type 2 diabetes. Lipid management, including statin medications, is recommended to reduce the risk of ASCVD for patients with type 2 diabetes.

Peer Mentoring Improves Diabetes Technology Use and Reduces Diabetes Distress Among Underserved Communities: Outcomes of a Pilot Diabetes Support Coach Intervention.

There are well-documented disparities in diabetes care outcomes and technology usage, stemming from differences in healthcare access, distrust in healthcare providers, and other factors. This study evaluated patient-level outcomes of a diabetes support coach (DSC) intervention aimed at improving underserved adults' diabetes technology use, diabetes distress, and HbA1c levels. As part of a Project Extension for Community Healthcare Outcomes (ECHO) Diabetes program, a social support intervention involving 28 DSCs was piloted at 33 Federally Qualified Health Centers (FQHCs) in Florida and California from May 2021 to May 2022.

Heterogeneous treatment effects of GLP-1RAs and SGLT2is on risk of Alzheimer's disease and related dementia in patients with type 2 diabetes: Insights from a real-world target trial emulation.

Introduction: This study assessed the heterogeneous treatment effects (HTEs) of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) on the risk of Alzheimer's disease and related dementias (ADRD).

Methods: This target trial emulation study included adults (≥ 50 years) with type 2 diabetes (T2D) and newly prescribed a GLP-1RA, SGLT2i, or other second-line glucose-lowering drugs (GLDs). A doubly robust learning approach was deployed to estimate the risk difference (RD) of ADRD and identify key subgroups.

Examining the relationship between adherence and the number of cardiometabolic medications: Findings for patients with type 2 diabetes within a Tribal health care system.

Background: The literature is inconclusive regarding the association between adherence and the number of concurrent prescribed medications. Among patients with type 2 diabetes (T2D), low medication adherence is linked with inadequate glycemic management and increased diabetes-related complications. Adherence to glucose-lowering, lipid-lowering, and antihypertensive medications may be impacted by the number of cardiometabolic medications taken by adults with T2D, including American Indian adults.

Food Rx: Integrating horticulture research to improve nutrition and health.

It is clear that the escalating epidemic of insulin resistance and type 2 diabetes has reached a crisis level in the United States, that overweight and obesity are drivers, and that diets and the food system have major roles. It is also clear that nutrition and medical research point to increased healthful fruit and vegetable intake as a key part of any strategy to manage the crisis. But although increasing healthful intake entails both expanding production of fruits and vegetables and improving their healthful characteristics, horticulture has generally been sidelined or taken for granted when strategies are envisioned.

Glycated hemoglobin and body mass index as mediators of GLP-1RAs and Alzheimer's disease and related dementias in patients with type 2 diabetes.

Introduction: Whether reductions in glycated hemoglobin (HbA1c) levels and body mass index (BMI) mediate the association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and Alzheimer's disease and related dementias (ADRD) risk is unknown.

Methods: This cohort study included 22,908 patients aged ≥ 50 years with type 2 diabetes (T2D) newly prescribed GLP-1RA or other second-line glucose-lowering drugs (GLDs). Causal mediation analysis was used to estimate to what extent the effect of GLP-1RAs on ADRD risk was attributable to lowering HbA1c or BMI.

GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related Dementias.

Importance: The association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) and risk of Alzheimer disease and related dementias (ADRD) remains to be confirmed.

Objective: To assess the risk of ADRD associated with GLP-1RAs and SGLT2is in people with type 2 diabetes (T2D).

Design, Setting, And Participants: This target trial emulation study used electronic health record data from OneFlorida+ Clinical Research Consortium from January 2014 to June 2023.

Regional trends and disparities in newer GLP1 receptor agonist initiation among real-world adult patients eligible for obesity treatment.

Aims: To characterize trends in the initiation of newer anti-obesity medications (AOMs) and determine factors associated with their use among obese/overweight populations.

Materials And Methods: This study utilized electronic health record data from OneFlorida+ (2015-2024). Adults eligible for AOMs were included, defined as having a body mass index (BMI) ≥30 kg/m or a BMI of 27-29.

Glucagon-Like Peptide-1 Receptor Agonists and Risk for Depression in Older Adults With Type 2 Diabetes : A Target Trial Emulation Study.

Background: Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown potential antidepressant effects, population studies yield inconsistent results.

Objective: To compare the risk for depression in older adults with type 2 diabetes (T2D) initiating treatment with GLP-1RAs versus sodium-glucose cotransporter-2 inhibitors (SGLT2is) or dipeptidyl peptidase-4 inhibitors (DPP4is).

Design: Target trial emulation study.

Trends and Disparities in Newer GLP1 Receptor Agonist Initiation among Real-World Adult Patients Eligible for Obesity Treatment.

Aims: To characterize trends in the initiation of newer anti-obesity medications (AOMs) and determine factors associated with their use among obese/overweight populations.

Materials And Methods: This retrospective study utilized electronic health record data from OneFlorida+ (2015-2024). Adults eligible for AOMs were included, defined as having a BMI ≥30 kg/m² or a BMI of 27-29.

Assessing perceptions of patient-centered care during telehealth visits provided via rural county Extension offices: an implementation pilot study.

Background: The use of telehealth to deliver healthcare remotely has increased significantly over the past two decades. Despite increased use among certain demographic groups, uptake among rural populations continues to lag when compared to urban populations. Barriers such as limited access to the internet and patient perceptions regarding the lower quality of remote visits on patient-provider relationships may contribute to lower use among rural populations.

Assessing the benefit-risk profile of newer glucose-lowering drugs: A systematic review and network meta-analysis of randomized outcome trials.

Aim: To comprehensively evaluate the benefits and risks of glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase 4 inhibitors (DPP4i), and sodium-glucose cotransporter 2 inhibitors (SGLT2i).

Materials And Methods: A systematic search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 2023 to identify randomized cardiovascular and kidney outcome trials that enrolled adults with type 2 diabetes, heart failure, or chronic kidney disease and compared DPP4i, GLP-1RAs, or SGLT2i to placebo. Twenty-one outcomes (e.

Project ECHO Diabetes Trial Improves Outcomes for Medically Underserved People.

Objective: The Project Extension for Community Healthcare Outcomes (ECHO) model is used in 180 countries to address chronic disease care through a provider empowerment, tele-education approach. Few studies have rigorously evaluated the impact of the program on patient outcomes using randomized designs.

Research Design And Methods: Implementation of an ECHO Diabetes program was evaluated using a stepped-wedge design with recruitment of 20 federally qualified health centers (FQHCs) across California and Florida with randomized, phased-in intervention entry.

Developing an automated algorithm for identification of children and adolescents with diabetes using electronic health records from the OneFlorida+ clinical research network.

Aim: To develop an automated computable phenotype (CP) algorithm for identifying diabetes cases in children and adolescents using electronic health records (EHRs) from the UF Health System.

Materials And Methods: The CP algorithm was iteratively derived based on structured data from EHRs (UF Health System 2012-2020). We randomly selected 536 presumed cases among individuals aged <18 years who had (1) glycated haemoglobin levels ≥ 6.

Risk of New-Onset Diabetes Before and During the COVID-19 Pandemic: A Real-World Cohort Study.

Background: Studies of new-onset diabetes as a post-acute sequela of SARS-CoV-2 infection are difficult to generalize to all socio-demographic subgroups.

Objective: To study the risk of new-onset diabetes after SARS-CoV-2 infection in a socio-demographically diverse sample.

Design: Retrospective cohort study of electronic health record (EHR) data available from the OneFlorida + clinical research network within the National Patient-Centered Clinical Research Network (PCORnet).

Not all healthcare inequities in diabetes are equal: a comparison of two medically underserved cohorts.

Introduction: Diabetes disparities exist based on socioeconomic status, race, and ethnicity. The aim of this study is to compare two cohorts with diabetes from California and Florida to better elucidate how health outcomes are stratified within underserved communities according to state location, race, and ethnicity.

Research Design And Methods: Two cohorts were recruited for comparison from 20 Federally Qualified Health Centers as part of a larger ECHO Diabetes program.

Medication Engagement, Determinants of Health, and A1C Levels Among Adults With Type 2 Diabetes within a Tribal Health System.

Purpose: The purpose of this study was to examine the association between determinants of health, medication engagement, and A1C levels in adults with type 2 diabetes (T2DM) receiving Tribal health and pharmacy services.

Methods: A retrospective analysis of 2020-2021 electronic health record data was conducted and included adult patients with T2DM using Choctaw Nation Health Services Authority prescribed ≥1 noninsulin glucose-lowering medication in 2020, had ≥1 A1C value in 2020 and 2021, and had a valid zip code in 2021. Patients receiving both insulin and other noninsulin glucose-lowering medication were included.