Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

CV Effects of Intensive Glycemic Control Evaluated

Diabetes Care; ePub 2017 Nov 28; Shah, et al

The incretin hormone glucagon-like peptide-1 (GLP-1) appears to play an important cardioprotective role in certain people with diabetes, researchers concluded after conducting a study involving 351 individuals. The ACCORD-MIND MRI substudy sought to 1) determine the influence of 2 genetic markers that had been found to be linked with CV mortality during intensive control, and 2) identify patients most likely to derive benefit from intensive control using a genetic risk score (GRS). Among the results:

  • A significant link was seen between GRS and active GLP-1 in patients who had been treated intensively during ACCORD; the effect was driven by rs57922.
  • C/C homozygotes, who benefitted from intensive treatment, showed a 22% increase in GLP-1 levels during follow-up.
  • Conversely, T/T homozygotes, who experienced increased cardiac mortality with intensive treatment, showed a 28% reduction in GLP-1 levels.
  • No link between active GLP-1 and GRS or rs57922 was seen in patients who had received standard treatment.

Citation:

Shah H, Morieri M, Marcovina S, et al. Modulation of GLP-1 levels by a genetic variant that regulates the cardiovascular effects of intensive glycemic control in ACCORD. [Published online ahead of print November 28, 2017]. Diabetes Care. doi:10.2337/dc17-1638.

This Week's Must Reads

Cochrane on Clinician-Focused Weight Loss Tactics, Cochrane; 2017 Nov 30; Flodgren, et al

Cochrane on Delaying Diabetes in People with IGT, Cochrane; 2017 Dec 5; Hemmingsen, et al

Consider Using This Risk Tool to Predict T2D Risk, Diabetes Care; ePub 2017 Dec 1; Bergmark, Bhatt, et al

Dysglycemia Cause in Overweight Adults, Teens, Diabetes Care; ePub 2017 Nov 28; Chen, et al

FDA Approves Semaglutide for Type 2 Diabetes, Novo Nordisk news release; 2017 Dec 5

Must Reads in Diabetes

Cochrane on Delaying Diabetes in People with IGT, Cochrane; 2017 Dec 5; Hemmingsen, et al

Consider Using This Risk Tool to Predict T2D Risk, Diabetes Care; ePub 2017 Dec 1; Bergmark, Bhatt, et al

Dysglycemia Cause in Overweight Adults, Teens, Diabetes Care; ePub 2017 Nov 28; Chen, et al

FDA Approves Semaglutide for Type 2 Diabetes, Novo Nordisk news release; 2017 Dec 5

Hospitalization in Those With, Without Diabetes, Diabetes Care; ePub 2017 Nov 17; Burrows, et al