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Screening for Glucose Perturbations and Risk Factor Management in Dysglycemic Patients With Coronary Artery Disease--A Persistent Challenge in Need of Substantial Improvement: A Report From ESC EORP EUROASPIRE V

OBJECTIVE

Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects.

RESEARCH DESIGN AND METHODS

The European Society of Cardiology’s European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016–2017) included 8,261 CAD patients, aged 18–80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated.

RESULTS

A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium–glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small.

CONCLUSIONS

Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.




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Glucosamine Use, Inflammation, and Genetic Susceptibility, and Incidence of Type 2 Diabetes: A Prospective Study in UK Biobank

OBJECTIVE

Glucosamine is a widely used supplement typically taken for osteoarthritis and joint pain. Emerging evidence suggests potential links of glucosamine with glucose metabolism, inflammation, and cardiometabolic risk. We prospectively analyzed the association of habitual glucosamine use with risk of type 2 diabetes (T2D) and assessed whether genetic susceptibility and inflammation status might modify the association.

RESEARCH DESIGN AND METHODS

This study analyzed 404,508 participants from the UK Biobank who were free of diabetes, cancer, or cardiovascular disease at baseline and completed the questionnaire on supplement use. Cox proportional hazards models were used to evaluate the association between habitual use of glucosamine and risk of incident T2D.

RESULTS

During a median of 8.1 years of follow-up, 7,228 incident cases of T2D were documented. Glucosamine use was associated with a significantly lower risk of T2D (hazard ratio 0.83, 95% CI 0.78–0.89) after adjustment for age, sex, BMI, race, center, Townsend deprivation index, lifestyle factors, history of disease, and other supplement use. This inverse association was more pronounced in participants with a higher blood level of baseline C-reactive protein than in those with a lower level of this inflammation marker (P-interaction = 0.02). A genetic risk score for T2D did not modify this association (P-interaction = 0.99).

CONCLUSIONS

Our findings indicate that glucosamine use is associated with a lower risk of incident T2D.




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Targeting CXCR1/2 Does Not Improve Insulin Secretion After Pancreatic Islet Transplantation: A Phase 3, Double-Blind, Randomized, Placebo-Controlled Trial in Type 1 Diabetes

OBJECTIVE

Reparixin is an inhibitor of CXCR1/2 chemokine receptor shown to be an effective anti-inflammatory adjuvant in a pilot clinical trial in allotransplant recipients.

RESEARCH DESIGN AND METHODS

A phase 3, multicenter, randomized, double-blind, parallel-assignment study (NCT01817959) was conducted in recipients of islet allotransplants randomized (2:1) to reparixin or placebo in addition to immunosuppression. Primary outcome was the area under the curve (AUC) for C-peptide during the mixed-meal tolerance test at day 75 ± 5 after the first and day 365 ± 14 after the last transplant. Secondary end points included insulin independence and standard measures of glycemic control.

RESULTS

The intention-to-treat analysis did not show a significant difference in C-peptide AUC at both day 75 (27 on reparixin vs. 18 on placebo, P = 0.99) and day 365 (24 on reparixin vs. 15 on placebo, P = 0.71). There was no statistically significant difference between treatment groups at any time point for any secondary variable. Analysis of patient subsets showed a trend for a higher percentage of subjects retaining insulin independence for 1 year after a single islet infusion in patients receiving reparixin as compared with patients receiving placebo (26.7% vs. 0%, P = 0.09) when antithymocyte globulin was used as induction immunosuppression.

CONCLUSIONS

In this first double-blind randomized trial, islet transplantation data obtained with reparixin do not support a role of CXCR1/2 inhibition in preventing islet inflammation-mediated damage.




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What math professors and k-12 teachers think of each other

By Michael Pershan, St. Ann’s School I. What do primary/secondary math educators think of the teaching that happens in colleges? And — the other way around — what do mathematics professors think of primary and secondary math teaching? I’m nearing … Continue reading




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The Dysfunction of Functions in Abstract Algebra

Kathleen Melhuish & Kristen Lew Texas State University “[Functions] are completely different, which is what makes this course so challenging.” – Abstract Algebra Student Functions are hard for students, even students in abstract algebra courses. Even if students have seen … Continue reading




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Teaching math in prison

By: Kristin Pfabe, Nebraska Wesleyan University “I am sad this class is going to be over,” said one student. “What am I going to do with myself?” asked another during the last week of an Intermediate Algebra class that I … Continue reading




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Help! I need to teach my course online and I’ve never done this before

By: Yvonne Lai, University of Nebraska-Lincoln Ray Levy, Mathematical Association of America This is cross-posted in MathValues and Abbe Herzig has written a companion post. Additional resources and future meetings are also available here: https://tinyurl.com/OnlineTalkshop. In times of crisis we … Continue reading




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Surprise! Transitioning to online teaching

 By Abbe Herzig, AMS Director of Education Many of us are experiencing stress as schools, colleges and universities move instruction out of the classroom. Fortunately, even if distance learning is new to you, it isn’t new, and there is a … Continue reading




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Online learning in the time of Coronavirus: Tips for students and the instructors who support them

Abbe Herzig, AMS Director of Education In the midst of the upheaval due to the Coronavirus, students and faculty are transitioning to new virtual classrooms. Many of us haven’t chosen to learn or teach, but here we are, making the … Continue reading




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Square peg in an octagonal hole

Interview with Ari Nieh, with commentary from Yvonne Lai Like many of us, I began teaching online this Spring. Unlike many of us, I began doing so at the start of the semester. I am co-teaching a class at Michigan … Continue reading




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Starting Earlier on Lifelong Learning

By: Matt Stamps, Yale-NUS College When Yale-NUS College reviewed the curriculum for its Mathematical, Computational, and Statistical (MCS) Sciences major in the autumn of 2018, I spent several weeks reading about mathematics programs at similar institutions.  A common learning objective … Continue reading




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Soccer: Germany's Bundesliga approved to return in mid-May

The Bundesliga -- Germany's top soccer league -- will be allowed to resume in May after German Chancellor Angela Merkel lifted some lockdown restrictions in the country on Wednesday amid the coronavirus pandemic.




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Dallas Cowboys sign former first-round pick Cameron Erving

The Dallas Cowboys agreed to terms with free-agent offensive lineman Cameron Erving, the team announced Wednesday.




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Cleveland Cavaliers planning to reopen training facility Friday

The Cleveland Cavaliers are planning to reopen their training facility for limited individual workouts amid the coronavirus pandemic.




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Taiwan baseball league to allow fans back in ballparks amid pandemic

A limited number of fans will be allowed to enter ballparks for games in Taiwan for the first time this season as stay-at-home orders continue to loosen amid the coronavirus pandemic.




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NFL lays out protocols for reopening of team facilities

The NFL outlined protocols Wednesday for the gradual reopening of team facilities amid the coronavirus pandemic.




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Ex-MLB players in spotlight as world turns to Asia for baseball

Playing in Taiwan once was a last option Justin Nicolino had to continue a professional baseball career. Now the former Miami Marlins pitcher is one of many ex-MLB players who provide entertainment for U.S. sports fans.




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Soccer: Bundesliga return includes Dortmund on May 16, Bayern Munich, May 17

The German Bundesliga released its full soccer schedule Thursday after German officials announced that the league is allowed to resume games after they were suspended due to the coronavirus pandemic.




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Weekend live sports include UFC 249, 14 baseball games in Asia

UFC 249 will be sandwiched between 14 live baseball broadcasts out of South Korea and Taiwan this weekend for American sports fans to watch as they wait for major sports leagues to return.




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Peyton Manning trash talks Tom Brady before May 24 golf match

Former star quarterback Peyton Manning delivered some trash talk to Tampa Bay Buccaneers star Tom Brady while they promoted their May 24 charity golf match.




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Korea's K-League soccer returns with rules against spitting, talking

K-League soccer resumed with a game behind closed doors Friday in South Korea, with players prohibited from spitting and talking.




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Japan offers weekend's only top-level event as horse racing struggles to resume

Coronavirus brings worldwide horse racing almost to a halt, with only one Grade 1 event on the weekend schedule, but rays of hope exist.




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New Orleans Saints release Pro Bowl OL Larry Warford

The New Orleans Saints released Pro Bowl offensive lineman Larry Warford after three seasons, the team announced Friday.




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Smartphone-Based Glucose Monitors and Applications in the Management of Diabetes: An Overview of 10 Salient "Apps" and a Novel Smartphone-Connected Blood Glucose Monitor

Joseph Tran
Oct 1, 2012; 30:173-178
Practical Pointers




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Diabetes in the Emergency Department: Acute Care of Diabetes Patients

Candace D. McNaughton
Apr 1, 2011; 29:51-59
Feature Articles




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Elevated Liver Function Tests in Type 2 Diabetes

Elizabeth H. Harris
Jul 1, 2005; 23:115-119
Feature Articles




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Opportunities and Challenges for Biosimilars: What's on the Horizon in the Global Insulin Market?

Lisa S. Rotenstein
Oct 1, 2012; 30:138-150
Features




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Case Study: A 43-Year-Old Man With Perineal Pain and Swelling

David J. Meier
Oct 1, 2001; 19:
Case Studies




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Case Study: Renal Disease in Type 1 Diabetes

William H. Herman
Apr 1, 2001; 19:
Case Studies




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Insulin Therapy: A Personal Approach

Mayer B. Davidson
Jul 1, 2015; 33:123-135
Feature Articles




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Injecting Insulin: Taking shots safely, correctly, and with little or no pain


Jan 1, 2013; 31:46-46
Patient Information




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Type 2 Diabetes in Children and Young Adults: A "New Epidemic"

Francine Ratner Kaufman
Oct 1, 2002; 20:
President's Pen




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Food, Culture, and Diabetes in the United States

Karmeen D. Kulkarni
Oct 1, 2004; 22:190-192
Practical Pointers




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International Classification of Diseases, 10th Revision, Coding for Diabetes

Joy Dugan
Oct 1, 2017; 35:232-238
Practical Pointers




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Treatment of Onychomycosis in Diabetic Patients

Jason A. Winston
Oct 1, 2006; 24:160-166
Feature Articles




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A 52-Year-Old Woman With Hypertension and Diabetes Who Presents With Chest Pain

George D. Harris
Jul 1, 2007; 25:115-118
Case Studies




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Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management

Vanessa J. Briscoe
Jul 1, 2006; 24:115-121
Feature Articles




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Improving Patient Adherence

Alan M. Delamater
Apr 1, 2006; 24:71-77
Feature Articles




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A Review of the Pathophysiology, Classification, and Treatment of Foot Ulcers in Diabetic Patients

Warren Clayton
Mar 1, 2009; 27:52-58
Features




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Treatment Approach to Patients With Severe Insulin Resistance

Timothy J. Church
Apr 1, 2016; 34:97-104
Feature Articles




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Self-Monitoring of Blood Glucose: The Basics

Evan M. Benjamin
Jan 1, 2002; 20:
Practical Pointers




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Standards of Medical Care in Diabetes--2018 Abridged for Primary Care Providers

American Diabetes Association
Jan 1, 2018; 36:14-37
Position Statements




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Case Study: Treating Hypertension in Patients With Diabetes

Evan M. Benjamin
Jul 1, 2004; 22:137-138
Case Studies




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Good to Know: Factors Affecting Blood Glucose


Apr 1, 2018; 36:202-202
Patient Education




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Using U-500 Insulin


Apr 1, 2012; 30:86-86
Patient Information




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Inpatient Management of Hyperglycemia and Diabetes

Vasudev Magaji
Jan 1, 2011; 29:3-9
Feature Articles




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Case Study: Diabetic Ketoacidosis in Type 2 Diabetes: "Look Under the Sheets"

Brian J. Welch
Oct 1, 2004; 22:198-200
Case Studies




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Diabetes and Your Joints


Jul 1, 2001; 19:
Patient Information




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Obesity in America: It's Getting Worse

Jennifer B. Marks
Jan 1, 2004; 22:
Editorials




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The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations

Edward A. Chow
Jul 1, 2012; 30:130-133
Diabetes Advocacy