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The article compares the outcomes of adults with type 1 diabetes using the Omnipod 5 system with either Dexcom G6 or Freestyle Libre 2 Plus sensors. The study found no significant differences in time spent in automode or in CGM metrics between the two sensor types. While there were some differences in glucose levels, the study suggests that sensor choice with Omnipod 5 does not result in clinically meaningful differences in performance or outcomes. The study highlights the need for further research to determine if one sensor system is superior in reducing time below range and glucose variability. [Extracted from the article]

This article discusses a study on the use of the Freestyle Libre system in adults with type 2 diabetes on basal-bolus insulin regimens. The study found that there was a small reduction in glycated hemoglobin (HbA1c) levels over a three-year period, with a larger reduction observed in those with higher baseline HbA1c levels. The study suggests that the use of Freestyle Libre may be beneficial for individuals with type 2 diabetes using basal-bolus insulin regimens. However, further research is needed to determine its effectiveness in other treatment regimens and non-insulin-treated type 2 diabetes. [Extracted from the article]

The article focuses on the real-world outcomes after one year of using Omnipod 5, a tubeless automated insulin delivery (AID) system for adults with type 1 diabetes in the UK. It reports significant improvements in time in range (TIR), HbA1c, and glucose variability, with no increase in time below range (TBR). It highlights that individuals with higher baseline HbA1c and lower bolus insulin use experienced the greatest improvements.

Angiogenesis restores blood flow to healing tissues, a process that is inhibited by high doses of glucocorticoids. However, the role of endogenous glucocorticoids and the potential for antiglucocorticold therapy to enhance angiogenesis is unknown. Using in vitro and in vivo models of angiogenesis in mice, we examined effects of (i) endogenous glucocorticoids, (ii) blocking endogenous glucocorticoid action with the glucocorticoid receptor antagonist RU38486, and (iii) abolishing local regeneration of glucocorticoids by the enzyme 11 [beta]-hydroxysteroid dehydrogenase type 1 (11 [beta]HSD1). Glucocorticoids, administered at physiological concentrations, inhibited angiogenesis in an in vitro aortic ring model and in vivo in polyurethane sponges implanted s.c. RU38486-enhanced angiogenesis in s.c. sponges, in healing surgical wounds, and in the myocardium of mice 7 days after myocardial infarction induced by coronary artery ligation. 11 [beta]HSD1 knockout mice showed enhanced angiogenesis in vitro and in vivo within sponges, wounds, and infarcted myocardium. Endogenous glucocorticoids, including those generated locally by 11 [beta]HSD1, exert tonic inhibition of angiogenesis. Inhibition of 11 [beta]HSD1 in liver and adipose has been advocated to reduce cardiovascular risk in the metabolic syndrome: these data suggest that 11 [beta]HSD1 inhibition offers a previously uncharacterized therapeutic approach to improve healing of ischemic or injured tissue. myocardial infarction | wound healing

Aims: Intensive glycaemic control is associated with substantial health benefits in people with type 1 diabetes. We sought to examine clinical and demographic factors associated with meeting glycaemic targets in type 1 diabetes. Methods: We conducted a cross‐sectional analysis of 4594 individuals with type 1 diabetes. The primary outcome of the study was assessing factors associated with meeting HbA1c targets. Secondary endpoints included factors associated with continuous subcutaneous insulin infusion (CSII) use and persistent C‐peptide secretion. Results: Socioeconomic deprivation was strongly associated with a lower likelihood of achieving an HbA1c <58 mmol/mol (7.5%) (20% in the most deprived quintile vs. 40% in the least deprived, p < 0.001). In multivariate analysis, absence of smoking history (OR 3.06, p < 0.001), flash monitoring (OR 1.49, p < 0.001), CSII (1.43, p = 0.022) and longer diabetes duration (OR 1.02 per year, p = 0.004) were independently associated with achieving HbA1c <58 mmol/mol (7.5%), whereas increasing age (OR 0.99 per year, p = 0.004) and C‐peptide <50 pM (OR 0.58, p < 0.001) were associated with a lower likelihood of meeting this target. Low C‐peptide (<50 pM) was less likely in men (OR 0.55, p < 0.001) and never smokers (0.44, p < 0.001) in multivariate analysis. Conclusions: Lower levels of deprivation, non‐smoking, higher C‐peptide, technology use, lower BMI and male gender were all associated with a higher likelihood of meeting HbA1c targets. Access to proven diabetes treatments is lower in the most deprived individuals. Urgent efforts are required to provide treatments which are effective across the socioeconomic gradient. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Minimal evidence supports the efficacy of flash monitoring in lowering HbA1c. We sought to assess the impact of introducing flash monitoring in our centre. Methods: We undertook a prospective observational study to assess change in HbA1c in 900 individuals with type 1 diabetes following flash monitoring (comparator group of 518 with no flash monitoring). Secondary outcomes included changes in hypoglycaemia, quality of life, flash monitoring data and hospital admissions. Results: Those with baseline HbA1c ≥58 mmol/mol (7.5%) achieved a median −7 mmol/mol (interquartile range [IQR] −13 to −1) (0.6% [−1.2 to −0.1]%) change in HbA1c (p < 0.001). The percentage achieving HbA1c <58 mmol/mol rose from 34.2% to 50.9% (p < 0.001). Median follow-up was 245 days (IQR 182 to 330). Individuals not using flash monitoring experienced no change in HbA1c across a similar timescale (p = 0.508). Higher HbA1c (p < 0.001), younger age at diagnosis (p = 0.003) and lower social deprivation (p = 0.024) were independently associated with an HbA1c fall of ≥5 mmol/mol (0.5%). More symptomatic (OR 1.9, p < 0.001) and asymptomatic (OR 1.4, p < 0.001) hypoglycaemia was reported after flash monitoring. Following flash monitoring, regimen-related and emotional components of the diabetes distress scale improved although the proportion with elevated anxiety (OR 1.2, p = 0.028) and depression (OR 2.0, p < 0.001) scores increased. Blood glucose test strip use fell from 3.8 to 0.6 per day (p < 0.001). Diabetic ketoacidosis admissions fell significantly following flash monitoring (p = 0.043). Conclusions/interpretation: Flash monitoring is associated with significant improvements in HbA1c and fewer diabetic ketoacidosis admissions. Higher rates of hypoglycaemia may relate to greater recognition of hitherto unrecognised events. Impact upon quality of life parameters was mixed but overall treatment satisfaction was overwhelmingly positive. [ABSTRACT FROM AUTHOR]

Summary: Objective: Radioiodine (RAI) is an effective treatment for Graves' thyrotoxicosis but is associated with a failure rate of 15% and may be a risk factor for thyroid eye disease (TED) and weight gain. We sought to examine predictors of RAI failure, weight gain, TED and patient satisfaction. Design: Retrospective cohort study. Patients: A total of 655 episodes of RAI in Graves' thyrotoxicosis patients (2006‐2015). Measurements: Biochemical assessment, including TFTs and thyrotropin receptor antibodies (TRAb), clinical features (eg, TED, weight and thionamide use) and patient questionnaire. Results: The treatment failure rate was 17%. Failure was greater with higher fT4 (P = 0.002) and higher TRAb (P = 0.004). Failure rate was 42.2% when TRAb >40 U/L. Median weight gain was 3.2 kg in those with normal fT4 prior to RAI and 5.8 kg when fT4 was elevated (P < 0.001). New TED developed in 7.6% but was not associated with post‐RAI dysthyroidism. Treatment satisfaction was generally high (median response 8/10). Conclusions: Treatment failure after RAI occurs in predictable groups and this should be reflected in the information provided to patients. Weight gain is common and may not entirely be explained by a return to pre‐thyrotoxic baseline. We were unable to detect any significant impact of post‐RAI dysthyroidism on weight gain, TED or thyroid symptoms in this large cohort. [ABSTRACT FROM AUTHOR]