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Relationship of Glucose Tolerance and Plasma Insulin to the Incidence of Coronary Heart Disease: Results from Two Population Studies in Finland

Kalevi Pyörälä
Mar 1, 1979; 2:131-141
Proceedings of the Kroc Foundation International Conference on Epidemiology of Diabetes and its Macrovascular Complications




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Coronary Heart Disease Incidence and Cardiovascular Mortality in Busselton with Reference to Glucose and Insulin Concentrations

T A Welborn
Mar 1, 1979; 2:154-160
Proceedings of the Kroc Foundation International Conference on Epidemiology of Diabetes and its Macrovascular Complications




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Consensus Development Conference on the Diagnosis of Coronary Heart Disease in People With Diabetes: 10-11 February 1998, Miami, Florida

American Diabetes Association
Sep 1, 1998; 21:1551-1559
Consensus Development Conference Report




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U.N. triples coronavirus aid appeal to help most vulnerable countries

The United Nations more than tripled its humanitarian aid appeal on Thursday from $2 billion to $6.7 billion to accommodate its updated global plan to help the poorest nations fight the coronavirus pandemic.




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Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease

Gregory G. Schwartz
May 1, 2020; 43:1077-1084
Emerging Therapies: Drugs and Regimens




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Coronavirus Is Spreading across Borders, But It Is Not a Migration Problem

Travel bans, border closures, and other migration management tools did not prove effective at blocking COVID-19 from spreading across international borders. Yet as governments have shifted from containment to mitigation with the coronavirus now in community transmission in many countries, these restrictions are a logical part of the policy toolkit in the context of social distancing and restricting all forms of human movement, as this commentary explores.




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A New Migration Policy for A New Era: A Conversation with Mexico's Interior Secretary Olga Sánchez Cordero

On her first official trip to Washington, DC, Secretary of the Interior Olga Sánchez Cordero offered a public address on Mexico’s new approach to migration policy at MPI. Her remarks and the event discussion were mostly conducted in Spanish, and this recording is of the simultaneous English interpretation. 




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Una nueva política migratoria para una nueva era: Una conversación con la Secretaria de Gobernación Olga Sánchez Cordero

Durante su primera visita oficial a Washington, DC, la Secretaria de Gobierno Olga Sánchez Cordero presento un discurso público sobre la nueva política migratoria de México en el Instituto de Políticas Migratorias.




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CDC to offer coronavirus guidance during webinar Jan. 31

The Centers for Disease Control and Prevention will provide interim guidance to clinicians regarding the coronavirus outbreak during a webinar at 2 p.m. EST Jan. 31.




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CDC reminds clinicians to use standard precautions, recommends isolating patients with coronavirus symptoms

In light of the “emerging, rapidly evolving” outbreak of the novel coronavirus 2019-nCoV, the Centers for Disease Control and Prevention is reminding clinicians to use standard precautions consistently and advising they isolate patients who show signs and symptoms of the virus.




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HIPAA fee limitation no longer applies to third-party access to health records

Following a ruling in federal court two days prior, the Department of Health and Human Services announced Jan. 25 that the Health Insurance Portability and Accountability Act Privacy Rule fee limitations do not apply to requests to transmit copies of records to third-parties.




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ADA releases coronavirus handout for dentists based on CDC guidelines

The handout covers strategies for helping prevent the transmission of suspected respiratory disease in the dental health care setting and answers frequently asked questions related to the virus, based on guidelines from the Centers for Disease Control and Prevention.




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ADEA cancels annual session due to coronavirus concerns

The American Dental Education Association announced March 9 it has cancelled its annual session due to the coronavirus disease, now named COVID-19.




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Connecticut Foundation for Dental Outreach postpones Mission of Mercy dental clinic amid coronavirus concerns

The Connecticut Foundation for Dental Outreach has postponed the Connecticut Mission of Mercy Free Dental Clinic scheduled for March 20-21 in Danbury, Connecticut, "out of abundant caution" amid the coronavirus disease outbreak.




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IADR, AADR cancel general session in light of coronavirus

The International Association for Dental Research and American Association for Dental Research have canceled their general session scheduled for March 18-21 in Washington, D.C., in light of the coronavirus disease outbreak.




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ADA adds frequently asked questions from dentists to coronavirus resources

With the coronavirus disease now deemed a pandemic by the World Health Organization, the American Dental Association updated its webpage on the disease March 11 to include a link to frequently asked questions from member dentists covering topics such as personal protective equipment and patient communications.




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ADA to Congress: Include dentists, patients in coronavirus legislation

The American Dental Association is urging Congress to include oral health care providers and their patients in any legislation proposed to confront the coronavirus disease outbreak.




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OSHA issues coronavirus guidance

The Occupational Safety and Health Administration has issued new guidance for health care providers to prepare workplaces for COVID-19.




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Association warns members on potential coronavirus-related phishing emails

The Association is asking member dentists and their dental teams to increase their vigilance over phishing emails as a result of the coronavirus, known as COVID-19.
Attackers often use emergencies as an opportunity to send fake emails tailored to that situation, the association said.




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ADA lobbies Congress’ coronavirus legislative package

As Congress works on legislation in response to the coronavirus disease outbreak, the ADA is working to ensure that those bills include provisions that are beneficial to dentists — particularly dental practice owners — and their patients.




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Association provides coronavirus infection control resources for dentists

The ADA is sharing with members the CDC guidelines on the use of personal protective equipment on its website dedicated to COVID-19.




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Senate passes coronavirus legislative package

The Senate and House have passed a coronavirus legislation package that includes three issues important to dentistry that will next head to the White House where President Donald Trump is expected to sign it into law.




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Labor Dept. releases new guidance in response to Families First Coronavirus Response Act

The U.S. Department of Labor Wage and Hour Division released new guidance March 26 to help workers and employers understand provisions included in the Families First Coronavirus Response Act.




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JADA’s new CSA Corner highlights ACE Panel survey results on HPV vaccine

Dentists’ comfort levels and perceived roles in discussing and administering the human papillomavirus vaccine appear to vary, according to the results of an American Dental Association Clinical Evaluators Panel survey published in The Journal of the American Dental Association.




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IEA doubts Russia’s commitment to OPEC accord

The Paris-based International Energy Agency on Friday cast doubt on whether Russia would meet its agreement with OPEC to cut crude oil output to support prices.




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Major corporations, cities buying into Texas' green energy boom

The U.S. wind industry is in a scramble to get a batch of turbine farms running in the next two years, before the federal government phases out a key tax credit.




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Rapid Corneal Nerve Fiber Loss: A Marker of Diabetic Neuropathy Onset and Progression

OBJECTIVE

Corneal nerve fiber length (CNFL) represents a biomarker for diabetic distal symmetric polyneuropathy (DSP). We aimed to determine the reference distribution of annual CNFL change, the prevalence of abnormal change in diabetes, and its associated clinical variables.

RESEARCH DESIGN AND METHODS

We examined 590 participants with diabetes [399 type 1 diabetes (T1D) and 191 type 2 diabetes (T2D)] and 204 control patients without diabetes with at least 1 year of follow-up and classified them according to rapid corneal nerve fiber loss (RCNFL) if CNFL change was below the fifth percentile of the control patients without diabetes.

RESULTS

Control patients without diabetes were 37.9 ± 19.8 years old, had median follow-up of three visits over 3.0 years, and mean annual change in CNFL was –0.1% (90% CI, –5.9 to 5.0%). RCNFL was defined by values exceeding the fifth percentile of 6% loss. Participants with T1D were 39.9 ± 18.7 years old, had median follow-up of three visits over 4.4 years, and mean annual change in CNFL was –0.8% (90% CI, –14.0 to 9.9%). Participants with T2D were 60.4 ± 8.2 years old, had median follow-up of three visits over 5.3 years, and mean annual change in CNFL was –0.2% (90% CI, –14.1 to 14.3%). RCNFL prevalence was 17% overall and was similar by diabetes type [64 T1D (16.0%), 37 T2D (19.4%), P = 0.31]. RNCFL was more common in those with baseline DSP (47% vs. 30% in those without baseline DSP, P = 0.001), which was associated with lower peroneal conduction velocity but not with baseline HbA1c or its change over follow-up.

CONCLUSIONS

An abnormally rapid loss of CNFL of 6% per year or more occurs in 17% of diabetes patients. RCNFL may identify patients at highest risk for the development and progression of DSP.




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Prognostic Significance of Long-term HbA1c Variability for All-Cause Mortality in the ACCORD Trial

OBJECTIVE

The association between high glycemic variability and all-cause mortality has been widely investigated in epidemiological studies but rarely validated in glucose-lowering clinical trials. We aimed to identify the prognostic significance of visit-to-visit HbA1c variability in treated patients in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial population.

RESEARCH DESIGN AND METHODS

We studied the risk of all-cause mortality in relation to long-term visit-to-visit HbA1c variability, expressed as coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV), from the 8th month to the transition. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (HR) and 95% CI.

RESULTS

Compared with the standard therapy group (n = 4,728), the intensive therapy group (n = 4,755) had significantly lower mean HbA1c (6.6% [49 mmol/mol] vs. 7.7% [61 mmol/mol], P < 0.0001) and lower CV, VIM, and ARV (P < 0.0001). In multivariate adjusted analysis, all three HbA1c variability indices were significantly associated with total mortality in all patients as well as in the standard- and intensive-therapy groups analyzed separately. The hazard ratios for a 1-SD increase in HbA1c variability indices for the all-cause mortality were 1.19 and 1.23 in intensive and standard therapy, respectively. Cross-tabulation analysis showed the third tertile of HbA1c mean and VIM had significantly higher all-cause mortality (HR 2.05; 95% CI, 1.17–3.61; P < 0.01) only in the intensive-therapy group.

CONCLUSIONS

Long-term visit-to-visit HbA1c variability was a strong predictor of all-cause mortality. HbA1c VIM combined with HbA1c mean conferred an increased risk for all-cause mortality in the intensive-therapy group.




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Blood Pressure Variability and Risk of Heart Failure in ACCORD and the VADT

OBJECTIVE

Although blood pressure variability is increasingly appreciated as a risk factor for cardiovascular disease, its relationship with heart failure (HF) is less clear. We examined the relationship between blood pressure variability and risk of HF in two cohorts of type 2 diabetes participating in trials of glucose and/or other risk factor management.

RESEARCH DESIGN AND METHODS

Data were drawn from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Veterans Affairs Diabetes Trial (VADT). Coefficient of variation (CV) and average real variability (ARV) were calculated for systolic (SBP) and diastolic blood pressure (DBP) along with maximum and cumulative mean SBP and DBP during both trials.

RESULTS

In ACCORD, CV and ARV of SBP and DBP were associated with increased risk of HF, even after adjusting for other risk factors and mean blood pressure (e.g., CV-SBP: hazard ratio [HR] 1.15, P = 0.01; CV-DBP: HR 1.18, P = 0.003). In the VADT, DBP variability was associated with increased risk of HF (ARV-DBP: HR 1.16, P = 0.001; CV-DBP: HR 1.09, P = 0.04). Further, in ACCORD, those with progressively lower baseline blood pressure demonstrated a stepwise increase in risk of HF with higher CV-SBP, ARV-SBP, and CV-DBP. Effects of blood pressure variability were related to dips, not elevations, in blood pressure.

CONCLUSIONS

Blood pressure variability is associated with HF risk in individuals with type 2 diabetes, possibly a consequence of periods of ischemia during diastole. These results may have implications for optimizing blood pressure treatment strategies in those with type 2 diabetes.




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Predicting the Risk of Inpatient Hypoglycemia With Machine Learning Using Electronic Health Records

OBJECTIVE

We analyzed data from inpatients with diabetes admitted to a large university hospital to predict the risk of hypoglycemia through the use of machine learning algorithms.

RESEARCH DESIGN AND METHODS

Four years of data were extracted from a hospital electronic health record system. This included laboratory and point-of-care blood glucose (BG) values to identify biochemical and clinically significant hypoglycemic episodes (BG ≤3.9 and ≤2.9 mmol/L, respectively). We used patient demographics, administered medications, vital signs, laboratory results, and procedures performed during the hospital stays to inform the model. Two iterations of the data set included the doses of insulin administered and the past history of inpatient hypoglycemia. Eighteen different prediction models were compared using the area under the receiver operating characteristic curve (AUROC) through a 10-fold cross validation.

RESULTS

We analyzed data obtained from 17,658 inpatients with diabetes who underwent 32,758 admissions between July 2014 and August 2018. The predictive factors from the logistic regression model included people undergoing procedures, weight, type of diabetes, oxygen saturation level, use of medications (insulin, sulfonylurea, and metformin), and albumin levels. The machine learning model with the best performance was the XGBoost model (AUROC 0.96). This outperformed the logistic regression model, which had an AUROC of 0.75 for the estimation of the risk of clinically significant hypoglycemia.

CONCLUSIONS

Advanced machine learning models are superior to logistic regression models in predicting the risk of hypoglycemia in inpatients with diabetes. Trials of such models should be conducted in real time to evaluate their utility to reduce inpatient hypoglycemia.




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Do You Understand Test Scores?

Do you understand the scores from cognitive assessments, academic assessments, and behavior rating scales? Understanding the basics of these assessments and what the test scores mean is extremely important when your child has been evaluated for special education. If you are like most parents and have lots of questions, I've written up the basics and compiled them onto one page. Read all about Understanding Test Scores at School Psychologist Files.



  • Special Education Assessment

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Pennsylvania, Texas, California among states lifting coronavirus restrictions Friday

California, Iowa, Pennsylvania and Rhode Island are among states that are loosening coronavirus restrictions Friday to gradually revive their economies.




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Migration &amp; Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed the state of play around the globe surrounding COVID-19 and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




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AAI Corp., a division of Textron, nabs $20.7M contract modification for Navy drone program

Textron was awarded a $20.7 million contract modification Friday for work on the Navy's Unmanned Influence Sweep System and Unmanned Surface Vehicle program.




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Record cold, snow overtakes northeastern U.S.

Americans across a large portion of the Northeast are in the midst of an unusually late-season blast of Arctic air courtesy of the polar vortex.




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China offers to help North Korea respond to coronavirus pandemic

China's President XI jinping offered Saturday to help North Korean leader Kim Jong Un respond to the coronavirus pandemic.




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How to Stop Waiting for ‘When Coronavirus Ends’

How many times have you thought, “When coronavirus ends, I will ______” — as if you’re putting off everything (or at least the things you most love) until then? They...




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Expanding Personal Limits in the Time of Coronavirus

While our external world begins to shrink during this time of social distancing and shelter-in-place health orders, we are challenged to expand our personal, internal limits and thresholds for almost...




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[ Investing ] Open Question : What does an investor do when his stock notifies him...the company confirms a record date for a forward two for one stock split?




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[ Credit ] Open Question : I'm 23 with a 536 credit score because I was stupid from ages 18-20. Is there any way to make it higher? ?

I have 2500 worth of debt and most of it has been turned over into collections 




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The Coronavirus Pandemic Puts Children at Risk of Online Sexual Exploitation

One conversation could keep your kids safe

-- Read more on ScientificAmerican.com



  • Mind
  • Behavior & Society

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Psychological Trauma Is the Next Crisis for Coronavirus Health Workers

Hero worship alone doesn’t protect frontline clinicians from distress

-- Read more on ScientificAmerican.com




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Teaching in the Time of Coronavirus, Part I

Hi all, 2020 has been a complicated year so far, and things are only going to get more complicated as the COVID-19 pandemic. I’ve been thinking a lot about teaching recently, (as I’m the instructor for a class of undergrad … Continue reading




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Immigrant Workers Are Vital to the U.S. Coronavirus Pandemic Response, But Disproportionately Vulnerable

WASHINGTON — Six million immigrant workers are at the frontlines of keeping U.S. residents healthy, safe and fed during the COVID-19 pandemic, according to a Migration Policy Institute (MPI) analysis of U.S. Census Bureau data issued today. While the foreign born represented 17 percent of the 156 million civilians working in 2018, they account for larger shares in pandemic-response frontline occupations: 29 percent of all physicians in the United States, 38 percent of home health aides and 23 percent of retail-store pharmacists, for example.




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Badrijani - Grilled Eggplants with a coriander and garlic Aioli

This recipe was featured on Foodie Tuesday, a weekly segment with Raf Epstein on Drive, 774 ABC Melbourne, 3:30 PM, courtesy of Alice in Frames. www.aliceinframes.com




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Salted caramel popcorn chocolate and rum cheesecake

Cheesecake: 1/4 cups chocolate or coconut biscuit crumbs 80g butter, melted 500g cream cheese, softened 1/4 cup caster sugar 2 teaspoons gelatine dissolved in 1/4 cup boiling water 200g dark chocolate melted and cooled slightly 2 splashes of rum 1 cup Baffle Creek Cream, softly whipped Salted Caramel Popcorn: 1 1/2 cup caster sugar 1/2 cup water 2/3 cup brown sugar 300ml thickened cream 1/2 - 1 tablespoon sea salt flakes 200g popcorn, popped




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GINGER AND CORIANDER CHUTNEY

TIS TIME TO DUST OFF THOSE CASSEROLE DISHES AND GET BRAISING FOR A DROP IN TEMPRATURE. THIS FLAVOURSIM CHUTTNEY IS A GREAT ENHANCMENT WITH CURRY DISHES, OR EVEN GREAT LIGHTLY SPREAD ON A WARM BAQUETTE WITH CHICKEN, LETTUCE ETC.