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Yesterday, The Lancet released the 10-year follow-up of the landmark Diabetes Prevention Program (DPP) Outcomes Study. Readers may recall that the original publication showed that in the 2.8 years of intervention, high-risk adults randomised to intensive lifestyle intervention had a risk reduction of 58% in the incidence for type 2 diabetes and a 31% risk reduction with metformin, compared with placebo. This report now examines whether these effects persist in the long term in 2766 of 3150 (88%) original patients enrolled for a median additional follow-up of 5·7 years. While all three groups were offered group-implemented lifestyle intervention, metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated) and the original lifestyle intervention group was offered additional lifestyle support. During the 10-year follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight.
In contrast to the marked differences in diabetes incidence between groups in the initial study, the incidence of diabetes in this follow-up study were similar between treatment groups: 5·9 per 100 person-years for lifestyle, 4·9 for metformin, and 5·6 for placebo. Nevertheless, when compared over the 10 years since enrollment in DPP, diabetes incidence was still 34% lower in the lifestyle group and 18% lower in the metformin group than with placebo. Thus, although the incidence rates of diabetes between the groups began to converge over the 10 year period, the cumulative incidence of diabetes remained lowest in the lifestyle group. It may be worthwhile to point out that over the 10 years, there was virtually no weight loss or weight gain in the groups – essentially at the end what all groups had was weight stabilisation.
Thanks for the update, this data along with the results from the LookAHEAD study have seemed to cause a resurgence our faith in lifestyle intervention for diabetes prevention and treatment!
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How does an incretin-based diabetes treatment differ from other treatments for type 2 diabetes? First, they address one of the underlying problems of type 2 diabetes by directly working on the beta cell.  Because of this, drugs like Victoza® have a major ability to lower glucose concentrations. Second, since their action depends on the level of glucose in the blood, they have a very low risk of causing low blood sugar (hypoglycemia) which distinguishes them from some other commonly used diabetes medications.
Third, and unlike most other diabetes medications, they do not increase weight.  And Victoza actually promotes weight loss. What symptoms would suggest the use of incretin-based treatment?  Is it (or could it be) used as a first line treatment? For the studies that indicated patients lost weight as a result of taking Victoza, how long were patients followed? What about Victoza as a weight loss drug in non-diabetics?  Are there studies planned for that?
Your safety information states that Victoza has been found to cause thyroid tumors in some rats and mice and that it is unknown whether this could be the case in humans as well.  What are the benefits of Victoza that outweigh such a potentially heavy risk? The drug warnings for Victoza note that in clinical trials, at least 8.6% of patients treated with Victoza developed anti-liraglutide antibodies (in other words, anti-Victoza antibodies). Given the risk seen in these studies of developing antibodies against both native and analog GLP-1, are there any symptoms or warning signs that patients taking Victoza should look out for that would indicate they were developing an autoimmune reaction to the drug?
He has written over 100 papers and articles on the treatment of diabetes, is an Editor of the Fourteenth edition of Joslin’s Diabetes Mellitus, and has been recognized both locally and nationally for clinical care in diabetes and for his research in diabetes and growth factors. My husband was given a sample of Victoza and used it one day until we learned it was no tested with patients currently on insulin. The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes.
The use of cannabis as a health treatment is highly controversial but now a new study has suggested that smoking the drug may help protect against type 2 diabetes.
The team at the Cardiovascular Epidemiology Research Unit at the Beth Israel Deaconess Medical Centre in Boston, analysed data on almost 5,000 patients who were quizzed about their use of recreational drugs as part of the National Health and Nutrition Survey between 2005 and 2010.

Tests showed that current users had 16% lower fasting insulin levels and reduced insulin resistance than those who had never used cannabis. Team leader Murray Mittleman said that the same benefits were seen among participants who had used the drug in the past but the associations were not as strong, indicating that the effects of cannabis use on insulin levels and insulin sensitivity wear off over time.
Smoking cannabis is illegal in many countries although there have been moves to make it permissible for medical conditions and rules are more lax in some countries, such as the Netherlands.
Being unaware of an unfavorable condition can be detrimental but not doing anything after knowing its potential adversities can be even more dangerous. In prediabetes, the blood sugar level is above normal but not high enough to be categorized as a symptom of type 2 diabetes. You need not fight with your body against odds but assist it in preparing better for the coming days so that diabetes is prevented. In a study published in the American Journal of Preventive Medicine, researchers found that prediabetic adults were more likely to be older men with lower educational status.
Overdose can cause low blood sugar besides other side effects like breathing difficulties, seizures, diarrhea and fatigue.
People over 45 years of age, having an American Indian, Hispanic or Asian descent, having inactive lifestyle, etc. With prediabetes, precautions and preventions can play a very important role in keeping long term adversities (including diabetes) away. Bigfoot was founded by Jeffrey Brewer, former CEO of JDRF International, and Bryan Mazlish, the mysterious “Bigfoot” in Dan Hurley’s piece for Wired Magazine, in November 2014, with the sole purpose of revolutionizing the treatment of Type 1 diabetes. Bigfoot recently received approval by the FDA of its Investigational Device Exemption (IDE) submission for a first clinical study of the smartloop automated insulin delivery system. 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups.
In contrast, the metformin group maintained most of the modest weight loss achieved in the first years of the trial. Interestingly, this finding was not attributable to a rebound effect in the lifestyle group but to a fall in incidence in the placebo and metformin groups that resulted in similar rates as achieved by lifestyle intervention, which changed little throughout follow-up. The study therefore supports the notion that an intensive lifestyle intervention and metformin can both prevent or delay the incidence of diabetes and that this effect can persist for as long as 10 years.
Readers will note that I have previously blogged about the importance of preventing weight gain rather than focussing all efforts on weight loss – especially when it comes to prevention.
Alan Moses, Novo Nordisk’s Chief Medical Officer, a few questions about Victoza and its use in the treatment of type 2 diabetes. Was the weight loss persistent for the course of the study and any follow-ups, or did patients regain weight over time? Yes.  Victoza® is currently in Phase III development for the treatment of obesity in individuals without diabetes, but these studies will take several years to complete.
Victoza® is not indicated for the treatment of type 1 diabetes.  Rather, it is approved only for the treatment of type 2 diabetes.
More concerning still, in the 52-week trial, 6.9% of patients treated with Victoza also developed antibodies against native GLP-1. Moses, MD is board certified by the American Board of Internal Medicine and has subspecialty certification in Endocrinology and Metabolism.
I would like to know about the safety of the use of this drug along with insulin and if there are any patients who are using this drug safely with their insulin- he is now taking 85 units Lantus along with 2000 mg metformin and 10 glipicide. I have been struggling for 26 years to keep my sugars stable but haven’t had any luck.
Researchers in the United States have found that regular users of the drug have better blood sugar control but the effects wear off over time. They found that 2,103 had never used cannabis, 975 had used the drug in the past but were not current users, and 579 had inhaled or ingested it in the past month.

Non-users also had larger waistlines and lower levels of high density lipoprotein (HDL or good) cholesterol, both of which are risk factors for type 2 diabetes. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar.
In the United States, 19 states have legalised cannabis for medicinal purposes by patients with one of several conditions including multiple sclerosis and cancer, while recreational use of the drug is now legal in two states, Colorado and Washington. Prediabetes may not place you among the millions of diabetics trying to manage each day with extraordinary efforts; however, being on the threshold certainly puts you at an increased risk of suffering from an array of illnesses. With timely intervention, it is possible to remain within the threshold and maintain a safe margin from the actual diabetic blood sugar levels. Prediabetes actually can be an opportunity to improve your health, align with the body and regress from the path of a permanent illness having no cure (diabetes). There are several things which can be done to enhance living and promote a constructive body functioning in order to have controlled blood sugar level. Being busy in everyday activities can restrict you from spending quality time practicing healthy habits. However, certain conditions can produce incorrect readings and other tests should be done to determine the exact blood glucose level. Their  mission is expressed in a system of care to transform the lives of people who depend upon the daily administration of insulin, a life-giving but also dangerous drug. The trial is slated to take place at three sites, each of which is a global leader in closed-loop insulin delivery research.
The most common adverse reactions reported in patients treated with Victoza® are headache, nausea, diarrhea, and anti-liraglutide antibody formation.  Immunogenicity-related events, including urticaria, were more common among Victoza-treated patients than among comparator-treated patients in clinical trials.
The  animal findings mean that Victoza is contraindicated in people who have a history of thyroid C-cell tumors, a very rare condition. Is there a risk that a type 2 diabetic patient treated with synthetic incretins will develop a previously absent autoimmune reaction to native peptides like GLP-1, further impairing insulin production and pancreatic performance? Since time is not generous, you need prompt action when you get to know that you are lingering on the threshold.
Include liquid oils in cooking as against the solid fats which can be high in saturated and tans fats.
Women having polycystic ovarian syndrome or who had suffered from gestational diabetes in life are at risk. Moving with unprecedented speed in medical device development, over the past 20 months they’ve assembled a team of 40 people and are driving toward commercialization of a cutting edge approach to improving the lives of people with T1D.
The nausea that occurs with Victoza is relatively mild in intensity and disappears quite rapidly after starting treatment.
Be motivated by keeping a good company and having a strong will to direct living towards meaningful outcomes.
Moses joined Novo Nordisk, Inc as Associate Vice President for Clinical Research and Medical Affairs – Endocrinology and in 2007 was named Chief Medical Officer, North America.
In January of 2008, he was named Corporate Vice President and Global Chief Medical Officer.
In this role, he is involved in the full spectrum of the diabetes focus of Novo Nordisk from drug discovery, through drug development, brand messaging, and the implications of diabetes for the company and for patients, healthcare professionals and for healthcare systems.

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