December 12, 2020 : Issue #1088

TOP STORIES — Diabetes News and Research

Long-Term Outcomes of Bariatric Surgery 

Degree of Diabetic Retinopathy Correlates with Cardiovascular Risk

Empagliflozin Effect on Major Adverse Kidney Events

I was speaking with our intern Antonio Bess from FAMU College of Pharmacy about all the new things to make you look thinner and younger. You can’t go more than 10 miles on the highway without seeing billboards for Bariatric Surgery, Laser Fat Removal, or a clinic where they will freeze your fat off. There are also many professional-looking devices on the internet that claim to accomplish the same thing.

The question is, do they work and are they worth spending the money for? This week, Dr. Bess has the results of a study looking at one of the methods, Bariatric Surgery, and how this method can deliver the best results to our diabetes patients, in our Laterpay feature. This is a great read because, as you know, with New Year’s right around the corner, your patients will be looking to you for advice.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Bariatric surgery has been proven to be an effective treatment of type 2 diabetes for people with obesity, but long-term outcomes have yet to be determined. 

Study finds patients with a higher degree of retinopathy severity had worse cardiovascular outcomes. 

A cohort study on the risk of major adverse kidney events for new patients initiated on empagliflozin versus other non-SGLT2I antihyperglycemics.

New research has found that hyperglycemia at hospital admission — regardless of diabetes status — is a crucial predictor of COVID-19-related death and severity among non-critical patients. Among more than 11,000 patients with confirmed COVID-19 from March to May 2020 in 109 hospitals, admission hyperglycemia independently predicted progression from non-critical to critical condition and death, regardless of prior diabetes history. Those with abnormally high glucose levels were more than twice as likely to die from the virus than those with normal readings (41.4% vs. 15.7%). They also had an increased need for a ventilator and intensive care unit (ICU) admission.

The retrospective, multicenter study was based on 11,312 adult patients with confirmed COVID-19 in 109 hospitals. They had a mean age of 67 years, 57% were male, and 19% had a diagnosis of diabetes. A total of 20% (n = 2289) died during hospitalization. Overall all-cause mortality was 41.1% among those with admission blood glucose levels above 180 mg/dL, 33.0% for those with glucose levels 140-180 mg/dL, and 15.7% for levels below 140 mg/dL. All differences were significant (P < .0001), but there were no differences in mortality rates within each blood glucose category between patients with or without a previous diagnosis of diabetes.

After adjustment for confounding factors, elevated admission blood glucose level remained a significant predictor of death. Compared to < 140 mg/dL, the hazard ratios for 140-180 mg/dL and > 180 mg/dL were 1.48 and 1.50, respectively (both P < .001). Use of mechanical ventilation and admission to intensive care also rose with higher admission blood glucose levels. For the composite of death, mechanical ventilation, and/or ICU admission, odds ratios for 140-180 mg/dL and > 180 mg/dL compared with < 140 mg/dL were 1.70 and 2.02, respectively (both P < .001).

Ann Med. Published online November 23, 2020. Abstract

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters:

Alexandria Bartley, PharmD. Candidate, Florida Agricultural & Mechanical University, College of Pharmacy and Pharmaceutical Sciences

Antonio Bess, Pharm D Candidate, Florida Agricultural & Mechanical University School of Pharmacy

Shana Indawala, PharmD Candidate, University of South Florida Health, Taneja College of Pharmacy

Aleksandra Kusic, PharmD Candidate, Florida A&M University, College of Pharmacy and Pharmaceutical Sciences

Olivia Shenouda, PharmD. Candidate, Florida A&M University School of Pharmacy

Jonnessia Winslow, PharmD Candidate, South College School of Pharmacy

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Diabetes In Control
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