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Aims: To assess whether impaired vestibular perception of self‐motion is a risk factor for unsteadiness and falls in elderly patients with type 2 diabetes (T2D). Materials and methods: 113 participants (65–75 years old) with T2D underwent tests of roll and pitch discrimination, postural stability (Berg Balance Scale, Modified Romberg Test, and quantitative posturography), clinical examination and blood chemistry analyses. Falls 1‐year after enrolment were self‐reported. We performed cluster analysis based on the values of the vestibular motion thresholds, and logistic stepwise regression to compare the clinical‐biochemical parameters between clusters. Results: We identified two clusters (VC1 n = 65 and VC2 n = 48 participants). VC2 had significantly (p < 0.001) higher (poorer) thresholds than VC1: mean pitch threshold 1.62°/s (95% CI 1.48–1.78) in VC2 and 0.91°/s (95% CI 0.84–0.98) in VC1, mean roll threshold 1.34°/s (95% CI 1.21–1.48) in VC2 and 0.69°/s (95% CI 0.64–0.74) in VC1. Diabetes duration was significantly (p = 0.024) longer in VC2 (11.96 years, 95% CI 9.23–14.68) than in VC1 (8.37 years, 95% CI 6.85–9.88). Glycaemic control was significantly (p = 0.014) poorer in VC2 (mean HbA1c 6.74%, 95% CI 6.47–7.06) than in VC1 (mean HbA1c 6.34%, 95% CI 6.16–6.53). VC2 had a significantly higher incidence of postural instability than VC1, with a higher risk of failing the Modified Romberg Test C4 (RR = 1.57, χ2 = 5.33, p = 0.021), reporting falls during follow‐up (RR = 11.48, χ2 = 9.40, p = 0.002), and greater postural sway in the medio‐lateral direction (p < 0.025). Conclusions: Assessing vestibular motion thresholds identifies individuals with T2D at risk of postural instability due to altered motion perception and guides vestibular rehabilitation. [ABSTRACT FROM AUTHOR]

Aim: To compare the efficacy and safety of saxagliptin/dapagliflozin and insulin glargine in people with latent autoimmune diabetes in adults (LADA). Methods: In this phase 2b multicentre, open‐label, comparator‐controlled, parallel‐group, non‐inferiority study, we randomly assigned 33 people with LADA who had a fasting C‐peptide concentration ≥0.2 nmol/L (0.6 ng/mL) to receive 1‐year daily treatment with either the combination of saxagliptin (5 mg) plus dapagliflozin (10 mg) or insulin glargine (starting dose: 10 IU), both on top of metformin. The primary outcome was the 2‐h mixed meal‐stimulated C‐peptide area under the curve (AUC), measured 12 months after randomization. Secondary outcomes were glycated haemoglobin (HbA1c) levels, change in body mass index (BMI), and hypoglycaemic events. Results: In the modified intention‐to‐treat analysis, the primary outcome was similar in participants assigned to saxagliptin/dapagliflozin or to insulin glargine (median C‐peptide AUC: 152.0 ng*min/mL [95% confidence interval {CI} 68.2; 357.4] vs. 122.2 ng*min/mL [95% CI 84.3; 255.8]; p for noninferiority = 0.0087). Participants randomized to saxagliptin/dapagliflozin lost more weight than those randomized to insulin glargine (median BMI change at the end of the study: −0.4 kg/m2 [95% CI −1.6; −0.3] vs. +0.4 kg/m2 [95% CI −0.3; +1.1]; p = 0.0076). No differences in HbA1c or in the number of participants experiencing hypoglycaemic events were found. Conclusions: Saxagliptin/dapagliflozin was non‐inferior to glargine in terms of β‐cell function in this 12‐month, small, phase 2b study, enrolling people with LADA with still viable endogenous insulin production. Weight loss was greater with saxagliptin/dapagliflozin, with no differences in glycaemic control or hypoglycaemic risk. [ABSTRACT FROM AUTHOR]

The article discusses the issue of obesity in individuals with type 1 diabetes (T1D). It highlights that overweight/obesity is becoming increasingly common in people with T1D, with rates varying depending on age, ethnicity, and country of residence. The lack of robust evidence in anti-obesity treatment for individuals with T1D is a significant concern. The article emphasizes the need for further research to address the issue of obesity in T1D and explores the potential drivers, features, and consequences of adipose tissue accumulation in this population. It also suggests several research questions that should be answered to gain a better understanding of the relationship between obesity and autoimmune diabetes. [Extracted from the article]

Glycated haemoglobin in the first year after diagnosis of type 1 diabetes is an independent risk factor for diabetic retinopathy: The IMDIAB 25 years follow-up study Effect of intensive diabetes therapy on the progression of diabetic retinopathy in patients with type 1 diabetes: 18 years of follow-up in the DCCT/EDIC. Keywords: HbA1c; metabolic memory; retinopathy; type 1 diabetes EN HbA1c metabolic memory retinopathy type 1 diabetes 3415 3419 5 10/05/23 20231101 NES 231101 BACKGROUND Intensive glycaemic control lowers the risk of microvascular complications.[1] This effect has been shown to persist for up to 18 years of follow-up.[[2], [4]] Whether the glycaemic control obtained during the first months after type 1 diabetes (T1D) onset has an impact on the future risk of chronic complications has not been clarified. Linear regression models were used to test the presence of any association between HbA1c at diabetes onset, mean-first-year HbA1c and HbA1c measured at last follow-up and to test baseline features associated with first-year HbA1c. [Extracted from the article]

Chitotriosidase (CHIT), a mammalian chitinase secreted by neutrophils and activated macrophages, is increased in both cardiovascular disease (CVD) and type 2 diabetes (T2D). Arterial stiffness rises early in T2D and increases the risk of CVD. The aim of this study is to evaluate CHIT activity as an early biomarker of arterial stiffness in people with T2D free from overt vascular complications. In this cross-sectional study, arterial stiffness as measured using standard pulse wave velocity (PWV) was evaluated in 174 people with T2D without overt vascular disease. Then, we measured CHIT serum activity with an electrochemiluminescence assay in two subgroups of participants: 35 with the highest (high-PWV) and 40 with the lowest (low-PWV) PWV values. CHIT activity was no different between the low-PVW and high-PWV groups (12.7 [9.6–17.9] vs. 11.4 [8.8–15.0] nmol/mL/h, respectively). Compared with the low-PWV group, the high-PWV participants were older (p < 0.001); had a longer duration of diabetes (p = 0.03); higher ankle–brachial index ABI (p = 0.04), systolic blood pressure (p = 0.002), diastolic blood pressure (p = 0.005), fasting blood glucose (p = 0.008), and HbA1c (p = 0.005); and lower eGFR (p = 0.03) and body mass index (BMI) (p = 0.01). No association was present with sex, duration of diabetes, age, BMI, peripheral blood pressure, laboratory parameters, and glucose-lowering medications or ongoing antihypertensive therapy. Although no association was found, this study provides novel data about the association of CHIT activity with CVD, focusing on a specific outcome (arterial stiffness) in a well-defined population of subjects with T2D without established CVD. [ABSTRACT FROM AUTHOR]