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Improved Pregnancy Outcomes In Women With Type 1 And Type 2 Diabetes But Substantial Clinic-to-clinic Variations: A Prospective Nationwide Study

Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study

Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study


, Volume 60, Issue9 , pp 16681677 | Cite as
Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
The aim of this prospective nationwide study was to examine antenatal pregnancy care and pregnancy outcomes in women with type 1 and type 2 diabetes, and to describe changes since 2002/2003.
This national population-based cohort included 3036 pregnant women with diabetes from 155 maternity clinics in England and Wales who delivered during 2015. The main outcome measures were maternal glycaemic control, preterm delivery (before 37weeks), infant large for gestational age (LGA), and rates of congenital anomaly, stillbirth and neonatal death.
Of 3036 women, 1563 (51%) had type 1, 1386 (46%) had type 2 and 87 (3%) had other types of diabetes. The percentage of women achieving HbA1c<6.5% (48mmol/mol) in early pregnancy varied greatly between clinics (median [interquartile range] 14.3% [7.722.2] for type 1, 37.0% [27.346.2] for type 2). The number of infants born preterm (21.7% vs 39.7%) and LGA (23.9% vs 46.4%) were lower for women with type 2 compared with type 1 diabetes (both p<0.001). The prevalence rates for congenital anomaly (46.2/1000 births for type 1, 34.6/1000 births for type 2) and neonatal death (8.1/1000 births for type 1, 11.4/1000 births for type 2) were unchanged since 2002/2003. Stillbirth rates are almost 2.5 times lower than in 2002/2003 (10.7 vs 25.8/1000 births for type 1, p=0.0012; 10.5 vs 29.2/1000 births for type 2, p=0.0091).
Stillbirth rates among women with ty Continue reading

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Overcoming Diabetes Burnout

Overcoming Diabetes Burnout

By: Johanna Murray, Journalism Major, Western Michigan University
Kathryn Finton walks into the classroom on the first day of class looking confident and excited. Her new students shuffle in after her quietly; I am one of them.
I notice a little box attached to the belt loop on her pants. It resembles that of a pager straight out of the 90s. In today’s setting, the pager sticks out, uncommon and foreign to college students of the 2000s.
Professor Finton introduces herself to the class, and introduces the pager attached to her hip as well. The pager turns out not to be a cool gadget from the 90s. Instead, a monitor to track her type 1 diabetes.
After a brief explanation of the little box, to cure the curious minds of her students, she continues on with the class. Her diabetes all but forgotten to the people listening to her words. However, for Professor Finton, her diabetes is something that is never forgotten.
I came to learn that the summer of her 12th year was the beginning of a drastic change in her life. Finton and her younger sister had been wearing matching dresses to their grandparent’s house when her parents noticed that she looked too small in the dress that had fit her well not long before. She was also using the bathroom more frequently than normal. Worried, her parents took her to the hospital the next day.
Twenty pounds under weight, Kathryn was diagnosed with type 1 diabetes. Her mother, in tears, told her “everything is going to be okay.”
“It didn’t feel like everything was going to be okay,” said Finton.
Her doctor had to explain not only what Continue reading

UCalgary researcher signs deal to develop nanomedicines for treatment of Type 1 diabetes

UCalgary researcher signs deal to develop nanomedicines for treatment of Type 1 diabetes

Photo courtesy Cumming School of Medicine
When Dr. Pere Santamaria arrived in Calgary in 1992 to join the Cumming School of Medicine, he never could have imagined he would make a groundbreaking discovery that would lead to a spinoff company. “When I arrived, I found out that the grant money I was expecting hadn’t come through,” says Santamaria, a professor in the Department of Microbiology, Immunology and Infectious Diseases and member of the Snyder Institute for Chronic Diseases. “So I had an empty lab with no research assistants and no salary. I had to beg my supervisor to give me $10,000 to start my research.”
Despite the rocky start, Santamaria has achieved something many scientists dream of — making a discovery that has practical applications for health care. Santamaria’s discovery revolves around the use of nanoparticles coated in proteins to treat autoimmune and inflammatory disorders.
“They can be modified for different diseases, such as Type 1 diabetes, multiple sclerosis and rheumatoid arthritis without compromising the entire immune system,” Santamaria explains. “Instead, they basically work to reset the immune system.”
Nanomedicine’s unique mechanism has the potential to disrupt the pharmaceutical industry entirely. Developing a new class of drugs is rare. With the assistance of Innovate Calgary, Santamaria started a company, Parvus Therapeutics Inc., to represent the technology and explore ways of bringing it to market. Announced in April 2017, Parvus entered into an exclusive deal with the Swiss pharma giant Novartis, hopefully leading Continue reading

Roundup: News from the Advanced Technologies & Treatments for Diabetes conference

Roundup: News from the Advanced Technologies & Treatments for Diabetes conference


Roundup: News from the Advanced Technologies & Treatments for Diabetes conference
This week in Paris, companies in the diabetes managment space came together at theAdvanced Technologies and Treatments for Diabetes conference to share news and, mostly, a lot of efficacy data. It's an exciting time for the space as closed-loop systems that allow people with diabetes to monitor their glucose continuously and automatically manage their insulin dosing get closer and closer to becoming a validated, regulated reality for people with Type 1 diabetes. We didn't make it out to Paris ourselves, but we're covering the news. We've written up some of the bigger stories from the conference earlier this week. Look below for a roundup of other digital health news from the show.
Nonprofit organizationT1D Exchangepublished a major study in Diabetes Care yesterday (and presented the research at the conference). The data re-affirms the FDA's recent clearance ofDexcom's CGM for insulin dosing. The study looked at 226 adult CGM users for six months. Of those, 149 dosed their insulin using the CGM and 77 used a fingerstick glucometer in addition, as is currently required for most CGMs. There was no difference in outcomes between the two groups.
"This study is an important step to support regulatory pathways for the automation of insulin delivery for people with type 1 diabetes, Dana Ball, executive director and co-founder of T1D Exchange, said in a statement. These data are supportive of the recent FDA decision to approve the Dexcom G5 indication for insulin dosing and removes a key obstacle Continue reading

Asthma drug shows promise in treating obesity and diabetes

Asthma drug shows promise in treating obesity and diabetes

ANN ARBOR, Mich. -- After 12 weeks of taking an anti-inflammatory asthma drug, obese patients with type 2 diabetes (link is external) showed a clinically significant drop in blood glucose.
The drug amlexanox, prescribed in Japan to treat asthma, appeared to free the metabolic system to burn more energy. A subset of patients had improved fatty liver disease and insulin sensitivity, a response seen among those who started the clinical trial with higher levels of inflammation in their fat tissue than others.
While the discovery at Michigan Medicine and the University of California at San Diego (link is external) is not ready for the clinic, it reveals an inflammatory link between obesity and type 2 diabetes.
Inflammation is the body’s natural response to injury and illness, but chronic inflammation caused by obesity is believed to promote insulin resistance, a main feature of diabetes.
“We are beginning to understand the role this form of internal inflammation plays in the development of chronic diseases like diabetes,” says lead study author Elif Oral, M.D., director of the MEND Obesity and Metabolic Disorder Program at Michigan Medicine (link is external). “Ultimately we may be able to personalize therapy based on the degree of inflammation present at baseline – which is a new concept.”
Oral is an endocrinologist and translational scientist at Michigan Medicine, the University of Michigan (link is external)’s academic medical center where the clinical trial was conducted and analyzed.
Tissue analysis was led by study author Alan R. Saltiel, Ph.D. (link is exter Continue reading

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