Diabetology, Volume 2, Issue 3 (September 2021) – 5 articles

The observational Real-Wecan study showed that canagliflozin 100 mg (CANA100) as an add-on therapy, and canagliflozin 300 (CANA300), switching from prior SGLT-2i therapy, significantly improved several cardiometabolic parameters in patients with T2DM. The aim of this sub-analysis was to assess the effectiveness and safety of canagliflozin in patients aged ≥65 years. The primary outcome of the study was the mean change in HbA1c over the follow-up period. A total of 583 patients met the inclusion criteria (39.5% ≥65 years), 279 in the cohort of CANA100 (36.9% ≥65 years; mean HbA1c 8.05%) and 304 in the cohort of CANA300 (mean age 61.1 years; 41.8% ≥65 years; mean HbA1c 7.51%). In the CANA100 cohort, older patients showed significant reductions in HbA1c (−0.78%) and weight (−4.5 kg). Patients aged ≥65 years switching to CANA300 experienced a significant decrease in HbA1c (−0.27%) and weight (−2.1 kg). There were no significant differences in HbA1c and weight reductions when the cohorts of patients <65 and ≥65 years were compared in a multiple linear regression model. The safety profile of canagliflozin was similar in both age groups. These findings support canagliflozin as an effective therapeutic option for older adults with T2DM. Full article

Diabetes mellitus (DM) is a widespread chronic disease with a prevalence that is expected to further increase in the near future. The classical management of DM includes the normalization of the glycometabolic profile and the evaluation of cardiac and cerebral vascular health by the intervention of an array of different specialists. However, so far, sexual dysfunctions are still a neglected complication in patients with DM, although there is an elevated prevalence of this long-term complication in male and female patients. Furthermore, some of them may represent a sign of vascular alteration and/or hypogonadism and require timely management to prevent the onset of major adverse cardiac events. This narrative review briefly summarizes the current evidence on epidemiology, pathogenesis, diagnosis, and therapy of erectile dysfunction in male patients with DM to support diabetologists in clinical practice. Full article

Background: Studies have shown that adolescents find diabetes management difficult and struggle with incorporating diabetes management into their daily life. A focus on issues adolescents perceive as important is necessary when designing high quality interventions aimed at improving health outcomes for adolescents with T1D. The present study aimed to provide: (1) a broad comprehensive reflection on issues adolescents with diabetes perceive as important; (2) a basis for developing a ‘Family Mirror’, specifically designed to generate dialogue in families with an adolescent with T1D. Methods: The qualitative data originate from 11 workshops with a total of 47 adolescents with diabetes between 8 and 18 years of age. Data were systematically analyzed. Results: Seven overarching, empirical themes were identified that provided an outline of aspects important to adolescents living with T1D: (1) Support, (2) Understanding, (3) Worries, (4) Limitations, (5) Independence, (6) Perceptions, and (7) Management. Several empirical indicators elaborated on the themes, thus creating a comprehensive reflection of life with T1D during adolescence. Conclusions: Given our comprehensive and broad approach to uncovering key aspects adolescents with diabetes perceive as important, we trust that the findings can be used as a basis for designing interventions intended for adolescents with T1D. Full article

Background: This study aimed to explore the effect of haematological markers as well as patient characteristics on stump healing in patients who underwent a lower limb amputation procedure. In addition, a practical model regarding factors that affected stump healing was developed. Methods: Patients who underwent a major lower limb amputation (above knee and below knee) at the Royal Infirmary of Edinburgh from the period of 2007 to 2010 were included in this study. A prognostic model utilizing backward stepwise logistical regression was developed to measure the probability of lower limb stump healing. The relationship between the dependent and independent variables was identified using univariate and multivariate logistic regression. Results: Three variables, namely serum sodium, serum creatinine and serum high density lipid cholesterol were identified which influenced stump healing. Patients with normal serum sodium were 75% more likely to have lower limb stump healing compared to that of patients with abnormal serum sodium (odds ratio [OR] 1.756; 95% confidence interval [CI] 1.048–2.942). Patients with normal serum creatinine were 66% more likely to have their stump healed (OR 1.664; 95% CI 0.94 to 2.946). The healing rate of patients with a normal level of serum high density lipid cholesterol was 75%, in contrast to patients with an aberrant level of serum high density lipids cholesterol (OR 1.753; 95% CI 1.061 to 2.895). The effectiveness of the retrospective stump-healing model was demonstrated by the area under the ROC curve (0.612), which was supported by the Hosmer and Lemeshow goodness-of-fit test (p = 0.879). Conclusions: Serum sodium, serum high density lipid cholesterol and serum creatinine have a strong correlation with lower limb stump healing. However, serum sodium and serum high density lipid cholesterol secondary to multiple co-morbidities in this cohort group could be altered secondary to disease pathology itself. Full article

An online risk prediction tool is developed to calculate a user’s risk of developing type II diabetes mellitus (T2DM). The risk prediction is based on the user’s input of medical lab information, such as age, sex, body mass index, fasting blood sugar, triglycerides, and high-density lipoprotein levels. The calculator is modelled using a logistic regression model, and it is trained using the medical records of over ten thousand Canadian patients. This newly developed tool is intended to serve physicians and patients in predicting future diabetes risk and take early preventive measures. Full article