Microvascular and macrovascular complications of diabetes: retinopathy, nephropathy, neuropathy, and cardiovascular risk.
An RCT finds adding a 2-3 week course of intravenous alprostadil to standard care improves the clinical response rate and lipids in diabetic foot or neuropathy, though the trial was unblinded. PICO summary and commentary.
A small post hoc COMET subgroup finds SGLT2 inhibitor use is associated with about half as many eye injections in diabetic macular edema with high blood pressure, an exploratory finding from 29 patients. PICO summary and commentary.
An RCT finds telemedicine-based home care achieves wound healing comparable to in-person care for diabetic foot ulcers, with no significant difference in healing but better self-management. PICO summary and commentary.
A machine-learning analysis of the VISTA trial finds aflibercept better preserves photoreceptor ellipsoid-zone integrity and reduces retinal fluid than laser in diabetic macular edema, with structure correlating with vision. PICO summary and commentary.
The FIVE-STAR mechanistic trial finds finerenone does not change arterial stiffness but reduces albuminuria in diabetic kidney disease, pointing to an intraglomerular-pressure mechanism. PICO summary and commentary.
A multicentre RCT finds adding cryopreserved amniotic membrane to standard care does not significantly improve healing in complex diabetic foot ulcers, though both arms healed well and it was safe. PICO summary and commentary.
A feasibility pilot finds a definitive trial of shockwave therapy for diabetic foot ulcers is deliverable, with only a descriptive (not powered) trend toward faster healing at the higher dose. PICO summary and commentary.
An RCT finds low-power laser therapy improves quality-of-life problem scores in diabetic polyneuropathy, but the neuropathy-severity difference between groups was not significant. PICO summary and commentary.
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