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Background: Injectable therapy is required when patients with type 2 diabetes (T2D) do not achieve glycemic control despite previous dietary and lifestyle modifications combined with oral antidiabetic therapy. While both Glucagon-like peptide-1 receptor agonists (GLP-1-RA) and insulin therapy are prescribed, real world evidence is lacking regarding relative therapeutic benefit. The objective of this study was to examine if there were changes in treatment and clinical measures in individuals who initiated any insulin vs. GLP-1 RA injectable therapy. Methods: All patients with T2D for at least five years who initiated any insulin or GLP-1 -RA therapy between 2010-2014 were identified in Clalit Health Services electronic medical records. Clinical measures and medication use at the time of therapy initiation (index-date) and one year post index date were examined and changes over the period were analyzed. Results: A total of 49,807 patients were identified: 41,049 received insulin and 8,758 GLP-1 RA. One year post index date, mean HbA1c (%) levels decreased in both groups (from 9.56 ± 2.22 to 8.24 ± 1.79 among insulin initiators and from 8.92 ± 1.43 to 7.96 ± 1.51 among GLP-1 RA initiators). Furthermore, 24.8% of GLP-1 RA initiators vs. 11.7% insulin initiators achieved >5% decrease in BMI level. There was a similar decrease in the percentage of patients purchasing oral hypoglycemic agents in both groups. No change was demonstrated in systolic and diastolic blood pressure between the 2 groups. Conclusions: This descriptive assessment found that clinical improvement was achieved in individuals that purchased insulin or GLP-1 RA, with a greater percentage achieving favorable HbA1c and BMI levels among those that initiated GLP-1 RA. Longer term follow-up with adjusted analyses is necessary in order to understand if the differential impact persists between these therapeutic treatments for individuals with T2D. Disclosure O. Reges: None. M. Leventer-Roberts: None. B. Curtis: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. I. Gofer: None. X. He: None. T. Karpati: None. G. Rubin: Employee; Self; Eli Lilly and Company. M. Leibowitz: None. A. Strizek: None. B.S. Feldman: None.

Aim To investigate the characteristics of participants in the Diabetes Conversation Map™ (Map™) program who had higher vs. lower compliance to the program, to determine if program tailoring and monitoring is needed among these groups. Methods This was a retrospective cohort study of 8990 patients enrolled in the Map™ program (low compliance [attending 0–1 sessions, n = 2759] and high compliance [attending ≥2 sessions, n = 6231]). Socio-demographic, clinical, health behaviors, and healthcare utilization characteristics were extracted. Multivariable stepwise logistic regression was used as the analysis strategy. Results Those who were of higher socio-economic status (OR = 1.567, 95%CI:1.317–1.865), who lived in urban area (OR = 1.501, 95%CI:1.254–1.798), with greater frequency of primary care visits (OR = 1.012, 95%CI:1.002–1.021), with medium (OR = 1.176, 95%CI:1.013–1.365) or high oral medication adherence (OR = 1.198, 95%CI:1.059–1.356), and with a greater frequency of blood glucose tests (OR = 1.102, 95%CI:1.033–1.175) had greater odds of being in the high compliance group. Conversely, those aged 35–44 (OR = 0.538, 95%CI:0.402–0.721) and 45–54 years (OR = 0.763, 95%CI:0.622–0.937), with longer Type 2 diabetes duration (OR = 0.980, 95%CI:0.967–0.993), with higher blood glucose levels (OR = 0.999, 95%CI:0.998–1.000), and current (OR = 0.659, 95%CI:0.569–0.762) or former smokers (OR = 0.831, 95%CI:0.737–0.938) had reduced odds for being in the higher compliance group. Conclusions Instructors in advance can target sub-groups to increase their attendance rates, and consequently improve their outcomes.

The German-Jewish intellectual Hannah Arendt (1906–1975) had famously opposed the establishment of a Jewish nation state in Palestine. During the Second World War, however, Arendt also spoke out repeatedly against the establishment of a binational Arab-Jewish state. Rejecting both alternatives, Arendt advocated for the inclusion of Palestine in a multi-ethnic federation that would not consist only of Jews and Arabs. Only in 1948, in an effort to forestall partition, did Arendt revise her earlier critique and endorse a binational solution for Palestine. This article offers a new reading of the evolution of Arendt's thought on Zionism and argues that her support for federalism must be understood as part of a broader wartime debate over federalism as a solution to a variety of post-war nationality problems in Europe, the Middle East and the British Empire. By highlighting the link between debates on wartime federalism and the future of Palestine, this article also underscores the importance of examining the legacy of federalism in twentieth century Europe for a more complete understanding of the history of Zionism.

This commentary serves as an introduction to Salo Baron’s obituary of Hannah Arendt and surveys the relationship between the two. Despite their significantly different backgrounds and public image, Arendt and Baron shared a close personal and professional relationship that began in the early 1940s and lasted throughout Arendt’s life. Baron and Arendt played leading roles in the project of salvaging Jewish culture from Europe during and in the aftermath of World War II. Their work for Jewish cultural reconstruction was based on a shared outlook on the ‘Jewish Question’. Both Arendt and Baron were deeply alarmed by the dangers ethnic nationalism in Europe posed for the Jews and promoted political programs that sought to overcome the nation-state in Europe, Palestine and the United States.

INTRODUCTION Medical school is a very stressful environment with multiple sources of stress, including academic, social and other issues. International medical students are exposed to additional stressors such as homesickness and culture shock. METHODS In order to assess the influence of cultural background on the level of perceived distress, we examined Israeli and American students studying at the same university during a period of terror. RESULTS We found clear differences between the 2 groups of students, with Americans reporting a higher level of anxiety and a poorer level of social functioning than the Israelis. Although there was no significant difference between the 2 groups in terms of their sense of safety, the American students reported a higher level of fear and more change in their daily activities to a greater extent than did the Israelis. CONCLUSIONS These findings underscore the effect of culture on students' responses to the same stressful stimuli and to a perceived dangerous environment. Faculty needs to be aware that cultural factors may affect students' adjustment to the medical school environment.