Search

Provides some practical guidelines for initiating insulin therapy in primary care practice. Reasons for using insulin in patients with type 2 diabetes; Concerns about hypoglycemia and patient willingness or ability to inject insulin; Link between glucose excursions and cardiovascular risk; Advantages of insulin therapy in the treatment of type 2 diabetes.

Safe and effective use of the Omnipod 5 System was demonstrated in adults and children with type 1 diabetes (T1D) during a 3-month pivotal study. Longer studies are needed to evaluate durability of glycemic benefit. Those completing the pivotal study were invited to continue system use for an additional 12 months, with 95% enrolling in the extension. We present results from the first 3-month follow-up. Participants aged 6-70y with T1D≥6 months and A1C<10% used the system in Automated Mode at home. Following the pivotal study, A1C was measured again after 3 months (6 months of total use). Safety and efficacy endpoints were occurrence of severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) and change in A1C, respectively. Participants (n=217) were aged (mean±SD) 24±17y with T1D duration 11±11y. A1C was lower after 6 months of system use than at baseline for children and adults (p<0.001, Table). For children, A1C was not significantly different between end of pivotal and the 3-month extension, while adults had an additional -0.1% decrease (p<0.01). There was 1 episode of DKA and no episodes of SH during the 3-month extension phase. The safety and improved glycemic outcomes from the pivotal study persisted for an additional 3 months of system use in this large cohort of participants, with 99% continuing into the next extension phase. Sustained reduction of A1C indicates the potential long-term benefit of the Omnipod 5 System. Disclosure: A. L. Carlson: Board Member; Self; JDRF, Other Relationship; Self; Medtronic, Research Support; Self; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk, Omnipod, Sanofi, UnitedHealth Group. J. Sherr: Advisory Panel; Self; Cecelia Health, Insulet Corporation, Medtronic, Consultant; Self; Insulet Corporation, Lexicon Pharmaceuticals, Inc., Lilly Diabetes, Medtronic, Research Support; Self; Dexcom, Inc., Insulet Corporation, Medtronic, Speaker's Bureau; Self; Lilly Diabetes. S. N. Mehta: None. L. M. Laffel: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompe, Insulogic LLC, Janssen Pharmaceuticals, Inc., Laxmi Therapeutic Devices, LifeScan, Lilly Diabetes, Medtronic, Provention Bio, Inc. V. Shah: Advisory Panel; Self; Medscape, Sanofi, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk, Sanofi, vTv Therapeutics. A. Bhargava: Research Support; Self; Abbott, AbbVie Inc., Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Boston Therapeutics, Inc., Covance Inc., Dexcom, Inc., Eli Lilly and Company, Gan & Lee Pharmaceuticals, Insulet Corporation, Janssen Research & Development, LLC, Kowa Pharmaceuticals America, Inc., Madrigal Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., Mylan N. V., Novo Nordisk, Poxel SA, Quintiles, Sanofi, Senseonics, Tolerion, Inc., Viking Therapeutics. R. S. Weinstock: Research Support; Self; Boehringer Ingelheim International GmbH, Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Kowa Research Institute, Inc., Medtronic, Tolerion, Inc. S. A. Macleish: Advisory Panel; Self; Insulet Corporation. D. Desalvo: Consultant; Self; Insulet Corporation, Research Support; Self; Insulet Corporation, Speaker's Bureau; Self; Dexcom, Inc. T. C. Jones: None. G. Aleppo: Consultant; Self; Dexcom, Inc., Insulet Corporation, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. A. B. Criego: Consultant; Self; Bigfoot Biomedical, Inc., Other Relationship; Self; Sanofi, Research Support; Self; Abbott Diabetes, Eli Lilly and Company, Insulet Corporation, Medtronic. B. A. Buckingham: Advisory Panel; Self; Medtronic, Tolerion, Inc., Research Support; Self; Beta Bionics, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. T. T. Ly: Employee; Self; Insulet Corporation. Omnipod 5 research group: n/a. G. P. Forlenza: Advisory Panel; Self; Medtronic, Consultant; Self; Beta Bionics, Inc., Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Research Support; Self; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. B. W. Bode: Advisory Panel; Self; Eli Lilly and Company, Consultant; Self; Bigfoot Biomedical, Inc., Companion Medical, Lexicon Pharmaceuticals, Inc., Medtronic, Novo Nordisk Inc., Zealand Pharma A/S, Research Support; Self; Abvance Therapeutics, Dexcom, Inc., Diasome Pharmaceuticals, Inc., Dompe, Eli Lilly and Company, Eyenuk, Inc., Insulet Corporation, Jaeb Center for Health Research, Medtro Funding: Insulet Corporation [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is a leading cause of death in people with type 2 diabetes (T2D). Recent cardiovascular (CV) outcomes trials have shown CV benefits for several GLP-1 receptor agonists and SGLT2 inhibitors. We aimed to evaluate T2D patients' awareness, perceptions, and behaviors regarding CVD and cardioprotective T2D drugs. An online survey was completed by 927 T2D patients of diverse socioeconomic backgrounds from an opted-in patient research panel in the U.S. Median respondent age was 64 and median duration of diabetes was 15 years. Half were taking a GLP-1 or SGLT2, a statistically robust sample of patients on these therapies. Questions covered perceptions of CVD disease; awareness of and interest in diabetes drugs that reduce CVD risk; knowledge of their own health metrics; physicians seen and frequency of discussions about CVD; self-assigned 'grades' on lifestyle behaviors known to reduce CVD risk. Most patients recognized the link between T2D and CVD: 61% strongly agreed that T2D increases CVD risk. Yet, only 29% think often about their risk of CVD. Awareness of CV benefits from some T2D therapies was also low (34% overall; 42% for those on SGLT2 or GLP-1). Interest in taking an additional cardioprotective diabetes agent aligned with awareness (37% overall; 42% for those on SGLT2 or GLP-1). While almost all knew their HbA1c and blood pressure, over 25% did not know their LDL cholesterol or other lipid levels. In the prior year, 31% of patients had seen a cardiologist and 17% had discussed CVD risk with an endocrinologist. Respondents generally ranked themselves 'average' to 'below average' on heart-healthy behaviors like exercise, weight, sleep, diet, and stress management. Although a majority of T2D patients are aware of the link between T2D and CVD, most are not actively managing their CV health, and few know that some T2D therapies are cardioprotective. These data suggest a need to better inform T2D patients about their risk for CVD, and steps they can take to reduce that risk. Disclosure: K.C. Stoner: Other Relationship; Self; Multiple companies and organizations in the diabetes field (greater than 10). E.N. Fitts: Other Relationship; Self; Various diabetes companies. D. Gopisetty: Other Relationship; Self; Various diabetes companies. A. Carracher: Other Relationship; Self; Other. C.S. Florissi: Other Relationship; Self; dQ&A has several clients (>10) in the diabetes field. M.J. Kurian: Other Relationship; Self; Other Company. J. Kwon: Other Relationship; Self; Various diabetes companies. P. Marathe: Consultant; Self; Close Concerns. P. Rentzepis: Other Relationship; Self; Various Diabetes Companies. J.B. Rost: Other Relationship; Self; dQ&A has several clients (>10) in the diabetes field. K.L. Close: Other Relationship; Self; Various diabetes companies. I.B. Hirsch: Consultant; Self; Abbott, Becton, Dickinson and Company, Big Foot, Roche Diabetes Care. Research Support; Self; Medtronic. M.N. Kosiborod: Consultant; Self; Amgen Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eisai Co., Ltd., GlaxoSmithKline plc., Glytec, LLC, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novartis AG, Novo Nordisk A/S, Sanofi. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. R. Wood: Other Relationship; Self; Multiple companies in the diabetes field (>10 companies). Funding: AstraZeneca [ABSTRACT FROM AUTHOR]

The article focuses on a randomized study that evaluated the clinical effectiveness of a device which combines a smart insulin pump with real-time continuous glucose monitoring (RT-CGM). Adults and adolescents with type 1 diabetes and insulin pump wearers were the participants of this study. It found that subjects with greater sensor utilization predicted a greater improvement in A1c levels.