Headlines From the ADA Scientific Sessions


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I recently had the opportunity to attend the 72nd Scientific Sessions of the American Diabetes Association[1] in Philadelphia. Here is a sampling of the research presented at the meeting:

Reducing A1C Less Than a Point Cuts CV Risk 45%
In an observational study from Sweden, people with Type 2 diabetes[2] who reduced their A1C level (an indicator of blood glucose control over the previous 2–3 months) from an average of 7.8% to 7.0% decreased their risk of cardiovascular death by 45% over a five-year follow-up compared to people who started with an average A1C level of 7.7% that remained stable or rose. Rates of coronary heart events and cardiovascular events were also significantly reduced in those who lowered their A1C.

For more information, read the article “ADA: Glycemic Control Reduces CV Risk”[3] or see the presentation abstract[4].

Artificial Pancreas Works in Young Children
In a small study in Boston’s Children’s Hospital, closed-loop insulin delivery via an artificial pancreas — a device consisting of a continuous glucose monitor and an insulin pump that work together to prevent high or low blood glucose without requiring input from the user — helped improve overnight high blood glucose in 10 children with Type 1 diabetes[5] under the age of seven.

The children were all admitted to the hospital and given a snack at 3 PM, along with dinner at 5 PM and another snack at 8 PM. The participants were then assigned to either an artificial pancreas or conventional insulin pump therapy, with all children switching to the alternate form of therapy the following night.

The researchers found that both forms of therapy kept the children in their target blood glucose range about the same amount of time, but that those using the artificial pancreas spent significantly less time above 300 mg/dl. They also experienced better lunchtime blood glucose control — even though they hadn’t received any premeal boluses — and did not have a greater rate of hypoglycemia[6] (low blood glucose) than when using the conventional insulin pump therapy.

“Closed-loop therapy has the potential to improve diabetes care for very young children,” noted researcher Andrew Dauber, MD. “We believe this is an underrepresented group in this area of research.”

To learn more, read the article “ADA: Closed-Loop Artificial Pancreas Works”[7] or see the abstract[8] from the ADA Scientific Sessions.

Metformin-Related B12 Deficiency Linked to Neuropathy
As we’ve previously reported, use of the popular Type 2 diabetes medicine metformin has been linked with vitamin B12 deficiency[9]. A small study in Slovenia suggests that deficiency of this vitamin may be linked with neuropathy[10], or nerve damage, in people with Type 2 diabetes.

According to researcher Jasna Klen, PhD, “We had a few patients complaining about peripheral neuropathy who hadn’t [had diabetes] very long, but they were on metformin. We decided to look at vitamin B12 deficiency.” They found that, of 84 people taking metformin for at least four years, 15 had vitamin B12 deficiency and 22 had borderline deficiency. Lower blood levels of B12 were associated with more severe peripheral neuropathy. The study authors note that peripheral neuropathy caused by vitamin B12 deficiency can be misdiagnosed as peripheral neuropathy caused by diabetes.

In response, some medical professionals are calling for more research into how much and what form of B12 supplementation[11] is ideal for people with metformin-related B12 deficiency.

To learn more, read the piece “ADA: Deficiency in Vitamin B12 With Metformin Linked to Neuropathy”[12] or see the presentation abstract[13] from the ADA Scientific Sessions.

Endnotes:
  1. 72nd Scientific Sessions of the American Diabetes Association: http://professional.diabetes.org/Congress_Display.aspx?TYP=9&CID=64574
  2. Type 2 diabetes: http://www.diabetesselfmanagement.com/articles/diabetes-definitions/type-2-diabetes
  3. “ADA: Glycemic Control Reduces CV Risk”: http://www.medpagetoday.com/MeetingCoverage/ADA/33262
  4. presentation abstract: http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=465c09cc-e66a-403c-a619-0f648526bd73&cKey=89a308da-61f7-4ed8-82ef-a5a7168ff33a&mKey=0F70410F-8DF3-49F5-A63D-3165359F5371
  5. Type 1 diabetes: http://www.diabetesselfmanagement.com/articles/diabetes-definitions/type-1-diabetes
  6. hypoglycemia: http://www.diabetesselfmanagement.com/articles/diabetes-definitions/hypoglycemia
  7. “ADA: Closed-Loop Artificial Pancreas Works”: http://www.diabetesincontrol.com/articles/diabetes-news/12971-ada-closed-loop-artificial-pancreas-works
  8. see the abstract: http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=efb654db-e9b5-473e-b338-f510e86008ae&cKey=ef8ebd8a-898f-458d-8005-eed27bbd2a00&mKey=0F70410F-8DF3-49F5-A63D-3165359F5371
  9. metformin has been linked with vitamin B12 deficiency: http://www.diabetesselfmanagement.com/Blog/Amy-Campbell/metformin_and_risk_for_vitamin_b12_deficiency/
  10. neuropathy: http://www.diabetesselfmanagement.com/articles/diabetic-complications/coping-with-painful-neuropathy/
  11. B12 supplementation: http://www.diabetesselfmanagement.com/Blog/Diane-Fennell/metformin-and-b12-supplementation/
  12. “ADA: Deficiency in Vitamin B12 With Metformin Linked to Neuropathy”: http://www.diabetesincontrol.com/articles/53-diabetes-news/12963-ada-deficiency-in-vitamin-b12-with-metformin-linked-to-neuropathy
  13. presentation abstract: http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=4188ec0e-1b99-45b4-b362-096e99d2c04f&cKey=a86537de-8a0c-401d-86a0-b2622ab0c778&mKey=0F70410F-8DF3-49F5-A63D-3165359F5371

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Diane Fennell: Diane Fennell has been an editor at Diabetes Self-Management magazine since 2003. She is currently the Editorial Director. (Diane Fennell is not a medical professional.)

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