The INTE-COMM Lancet trial finds community-based care matches facility care for stable HIV, diabetes, and hypertension in sub-Saharan Africa. PICO summary and expert commentary.
Browsing: Type 2 Diabetes
Clinical evidence summaries for type 2 diabetes, including glycaemic therapies, cardiovascular outcomes, kidney protection, complications, technology, obesity, and long-term safety.
The CREDENCE trial demonstrated that canagliflozin reduced the composite of end-stage kidney disease, doubling of serum creatinine, or renal or cardiovascular death by 30% in patients with type 2 diabetes and albuminuric chronic kidney disease, becoming the first dedicated renal outcomes trial to demonstrate that an SGLT2 inhibitor could substantially slow the progression of diabetic nephropathy.
The DECLARE-TIMI 58 trial demonstrated that dapagliflozin did not reduce 3-point MACE compared with placebo but significantly reduced the composite of cardiovascular death or hospitalisation for heart failure, driven entirely by a 27% reduction in heart failure hospitalisation, in the largest and most broadly representative SGLT2 inhibitor cardiovascular outcomes trial conducted to date.
The CANVAS Programme demonstrated that canagliflozin reduced major adverse cardiovascular events by 14% in patients with type 2 diabetes at high cardiovascular risk, but identified an approximately twofold increase in lower-extremity amputation risk, primarily at the toe or metatarsal level, requiring careful patient selection and monitoring.
The EMPA-REG OUTCOME trial demonstrated that empagliflozin reduced cardiovascular death by 38% and heart failure hospitalisation by 35% in patients with type 2 diabetes and established cardiovascular disease — the first glucose-lowering agent to show a mortality benefit in a cardiovascular outcomes trial.
A three-year follow-up finds most people who reached diabetes remission via intermittent calorie restriction maintained it without ongoing intervention. PICO summary and commentary.
An RCT finds the weekly GLP-1 agonist PEG-Loxe produces large dose-dependent weight loss in super-obese patients with type 2 diabetes. PICO summary and expert commentary.
An ex-vivo study finds early empagliflozin dampens NLRP3 inflammasome activity in macrophages from post-MI diabetic patients, a mechanistic signal. PICO summary and commentary.
A small exploratory study finds combining empagliflozin with linagliptin shifts urinary microbiota toward a healthy pattern in type 2 diabetes, while empagliflozin alone raises some uropathogens; infection rates were not measured. PICO summary and commentary.
A GRADE substudy finds adults adding a second drug to metformin maintain high medication adherence over 3 years with small between-drug differences, while lower adherence robustly predicts worse glycaemic control. PICO summary and commentary.