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79
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Daily Update
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7 JUNE 2019
An educational initiative by
79 TH SCIENTIFIC SESSIONS OF THE
AMERICAN DIABETES ASSOCIATION
SAN FRANCISCO, CA • JUNE 7 - 11 , 2019
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79 TH SCIENTIFIC SESSIONS OF THE
AMERICAN DIABETES ASSOCIATION
SAN FRANCISCO, CA • JUNE 7 - 11 , 2019
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The CREDENCE and CARMELINA trials, for The PIONEER trial program, comparing the
which key findings will be reviewed and new efficacy and safety of orally administered
data analyses presented. These major trials peptide drugs with other antihyperglycemic
explored the effects of canagliflozin and agents.
linagliptin, respectively, in patients with type 2
diabetes at high risk for renal and cardiovascu-
lar complications.
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Saturated fat should be replaced with William Cefalu, MD, the ADA's Chief
unsaturated fat to reduce low-density Scientific, Medical, and Mission Officer,
lipoprotein cholesterol, total cholesterol, stated that the ADA “strongly encourages an
and the risk for cardiovascular disease. individualized approach that includes regular
review of nutrition status for all people living
Research indicates that reductions in with diabetes. Reassessment of an individual's
hemoglobin A1c with medical nutrition nutritional plan is particularly important during
therapy in type 2 diabetes (T2D) can be significant life and health status changes…
equal to or greater than reductions with Working with a team of health providers
medications. including a registered dietician or certified
diabetes educator is fundamental to effectively
Medical nutrition therapy can be
manage[ing] diabetes and prediabetes.”
important in the management and
prevention of diabetes complications
including gastroparesis, cardiovascular
disease, and chronic kidney disease.
Exercise, Behavioral
National data suggest that people with Treatment Improve
diabetes do not receive any formal
diabetes education, so referring adults Outcomes in Comor-
with T1D or T2D to personalized, diabe- bid T2D & Depression
tes-focused medical nutrition therapy
upon diagnosis and throughout life is an
San Francisco, California, Friday 7th
imperative component of care.
June, 2019: Exercise and/or behavioral
treatment interventions may provide clinically
For patients with prediabetes, the
meaningful improvements in depression
panel made the following recommen-
outcomes in adults with type 2 diabetes
dations.
(T2DM) and major depressive disorder
Referral to an intensive behavioral (MDD), according to a study presented today
lifestyle intervention program to improve 7th June 2019 at the 79th Scientific Sessions of
eating habits, increasing physical the ADA.
activity to at least 150 min/wk, and a
Mary de Groot, Ph.D., from Indiana University
7% to 10% loss of initial body weight if
in Indianapolis, and colleagues randomly
indicated.
assigned adults with T2DM for at least one
Counseling by healthcare providers year with coexisting MDD to cognitive behav-
should focus on prevention and diagno- ioral therapy (CBT; 10 sessions over 12 weeks;
sis and treatment of disordered eating. 36 patients), community-based exercise
(EXER; 12 weeks including six sessions with a
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79 TH SCIENTIFIC SESSIONS OF THE
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79 TH SCIENTIFIC SESSIONS OF THE
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79 TH SCIENTIFIC SESSIONS OF THE
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“Congratulations, Dr. Seaquist, on this tremen- Dr. Seaquist has mentored female junior
dous achievement, and thank you for your faculty members who are actively involved in
significant contributions supporting women diabetes, obesity and insulin resistance
and health care providers and researchers in research. She has also served in numerous
diabetes,” said the ADA's Chief Scientific, mentorship and leadership positions with the
Medical and Mission Officer and President of ADA, including serving as the 2014 President
the ADA Research Foundation William T. of Medicine and Science, as a member of the
Cefalu, MD. “For those of us who knew and ADA's National Board of Directors and the
respected Dr. Jovanovic, I can't imagine Pathway to Stop Diabetes Mentor Advisory
anyone more rewarding than Dr. Seaquist to
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AMERICAN DIABETES ASSOCIATION
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79 TH SCIENTIFIC SESSIONS OF THE
AMERICAN DIABETES ASSOCIATION
SAN FRANCISCO, CA • JUNE 7 - 11 , 2019
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ended early due to efficacy. Incorporating ence includes adult and pediatric endocrinol-
these findings into the Standards of Care now ogy, epidemiology, public health, lipid
gives providers the latest evidence-based research, hypertension, preconception plan-
recommendations to treat people with type 2 ning and pregnancy care. For the 2019
diabetes and diabetes-related chronic kidney Standards of Care, two designated representa-
disease. Our Mission at the ADA is to improve tives from the American College of Cardiology
the lives of all those with diabetes and provid- (ACC) reviewed, provided feedback and
ing timely updates to our Standards of Care endorsed the recommendations for cardiovas-
can help achieve that goal. Improving care for cular disease and risk management on behalf
the millions of Americans living with diabetes of the ACC. The ACC designated representa-
cannot wait,” said the ADA's Chief Scientific, tives also reviewed and approved the updates
Medical and Mission Officer William T. made to the cardiovascular disease and risk
Cefalu, MD. management section. The PPC performs an
extensive, global clinical diabetes literature
The Standards of Care provide the latest in search each year for the annual Standards of
comprehensive, evidence-based recommenda- Care update, supplemented with input from
tions for the diagnosis and treatment of chil- ADA leaders and staff and the medical com-
dren and adults with type 1, type 2 or gesta- munity at-large. Members of the PPC must
tional diabetes; strategies to improve the disclose potential conflicts of interest with
prevention or delay of type 2 diabetes; and industry and/or relevant organizations; these
therapeutic approaches that reduce complica- disclosures are available on page S184 of the
tions and positively affect health outcomes. 2019 Standards of Care.
Beginning in 2018, the ADA updates and
revises the online version of the Standards of
Care throughout the year, with annotations for No Evidence of Legacy
new evidence or regulatory changes that merit
immediate incorporation. The online version of
Effect Seen for Inte-
the Standards of Care will include any nsive Glucose Lower-
research updates or policy changes that are
approved throughout 2019.
ing
Updates to the Standards of Care are estab- San Francisco, California, Friday 7th
lished and revised by the ADA's Professional June, 2019: There seems to be no evidence
Practice Committee (PPC). The committee is a of a legacy effect or mortality benefit for
multidisciplinary team of 14 leading U.S. intensive glucose control among military
experts in the field of diabetes care and veterans with type 2 diabetes, according to a
includes physicians, diabetes educators, study published in the June 6 issue of the New
registered dietitians and others whose experi- England Journal of Medicine.
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Peter D. Reaven, M.D., from the Phoenix interval, 0.78 to 1.06; P = 0.23; hazard ratio
Veterans Affairs Health Care System, and for death, 1.02; 95 percent confidence
colleagues report 15-year follow-up for interval, 0.88 to 1.18). During an extended
intensive versus standard glucose lowering interval of separation of the glycated hemoglo-
following a trial involving 1,791 military bin curves, the risk for major cardiovascular
veterans with type 2 diabetes. disease outcomes was reduced (hazard ratio,
0.83; 95 percent confidence interval, 0.70 to
The separation of glycated hemoglobin curves 0.99). After equalization of the glycated
between the intensive- and standard-therapy hemoglobin levels, the benefit did not persist
groups averaged 1.5 points during the trial (hazard ratio, 1.26; 95 percent confidence
and declined after the trial ended. The interval, 0.90 to 1.75).
researchers found that the risks for major
cardiovascular events or death were not lower “A major implication of the Veterans Affairs
in the intensive-therapy group versus the Diabetes Trial follow-up study is that older
standard-therapy group during a period of 15 patients with advanced diabetes should not
years of follow-up (active treatment plus post- expect long-term cardiovascular benefits from
trial observation; hazard ratio for primary intensive glycemic control,” write the authors of
outcome, 0.91; 95 percent confidence an accompanying editorial.
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79
SCIENTIFIC SESSIONS
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An educational initiative by