October 25, 2017. Continuous glucose monitoring (CGM) systems automatically track blood glucose levels over 24 hours, offering valuable information for people with diabetes. Due to challenges standardizing and understanding this technology, however, these devices remain underutilized. To help maximize the potential for CGM systems in diabetes management, a team of experts from the American Diabetes Association and the European Association for the Study of Diabetes has issued a joint scientific statement regarding the most effective and appropriate use of this technology.
October 23, 2017. The US Food and Drug Administration (FDA) has approved a new, extended-release formulation of exenatide, a glucagon-like peptide-1 (GLP-1) receptor agonist, for adults with type 2 diabetes. The new formulation, called Bydureon BCise, is delivered via a once-weekly, single-dose autoinjector device that continuously releases consistent, therapeutic levels of exenatide. In clinical trials, the drug has been shown to lower A1C levels and promote weight loss, both as monotherapy and in combination with metformin, a sulfonylurea, or a thiazolidinedione.
October 18, 2017. An advisory committee of the US Food and Drug Administration (FDA) voted to recommend approval of Novo Nordisk’s semaglutide, a glucagon-like peptide 1 receptor agonist (GLP-1 RA), to improve glycemic control in adults with type 2 diabetes (T2D). The decision was based on efficacy and safety data from 8 clinical trials, which involved more than 8,000 adults with T2D.
August 5, 2017. The effect of empagliflozin, a sodium-glucose cotransporter 2 (SGLT-2) inhibitor, on urinary albumin-to-creatinine ratio (UACR) was explored in an analysis of data from EMPA-REG OUTCOME, a randomized, placebo-controlled trial. In the exploratory analysis, 6,953 patients were stratified according to albuminuria status at baseline (normo-, micro-, or macroalbuminuria) and data were pooled for the empagliflozin arms (10 and 25 mg) vs placebo. UACR levels were assessed at 12 and 164 weeks.
July 24, 2017. This post-hoc analysis of 2 large, randomized controlled trials (EDITION 1 and EDITION 2) evaluated the effect of once-daily insulin glargine 300 U/mL (Gla-300) vs glargine 100 U/mL (Gla-100) over 6 months on blood glucose and hypoglycemia in patients with type 2 diabetes switching from twice-daily insulin. Change from baseline in A1C, assessed as least-squares mean difference, was similar for both groups in both studies: (EDITION 1, -0.01%; 95% confidence interval [CI]: -0.27%-0.24%; EDITION 2, 0.16%; 95% CI: -0.25%-0.57%).
October 3, 2017. The US Food and Drug Administration (FDA) has approved a new, faster-acting injected mealtime insulin called Fiasp ("fast-acting insulin aspart"). Fiasp is similar to the mealtime insulin NovoLog but with a quicker onset and offset; Fiasp can be used as late as 20 minutes after starting a meal (although before-meal administration is preferable), and the more rapid offset reduces the risk of post-meal hypoglycemia. Fiasp will be offered at the same price as NovoLog.
September 27, 2017. The US Food and Drug Administration (FDA) has approved the first continuous glucose monitoring system that does not require a "fingerstick" blood sample. The FreeStyle Libre Flash Glucose Monitoring System uses a small sensor wire inserted below the skin's surface. By waving a mobile reader above the sensor, a user can determine if glucose levels are too high or low, as well as see changes in glucose levels that can inform diabetes treatment decisions. The system can be worn for up to 10 days after a 12-hour start-up period.
September 15, 2017. Evolocumab is a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor that reduced cardiovascular (CV) events and low-density lipoprotein cholesterol over a median of 2.2 years in the randomized FOURIER trial (N=27,564). This prespecified post-hoc analysis investigated the efficacy and safety of evolocumab vs placebo among patients with (n=11,031) and without diabetes (n=16,533) at baseline. The impact of evolocumab on the risk of developing diabetes also was investigated.
September 13, 2017. The EMPA-REG OUTCOME trial investigated the impact of empagliflozin, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, on 7,020 patients with type 2 diabetes (T2D) and cardiovascular (CV) disease. This analysis of a subset of patients with T2D, CV disease, and chronic kidney disease at baseline found that empagliflozin is not only safe, but improves clinical outcomes and reduces mortality when added to standard of care treatment.
September 14, 2017. This 24-week double-blind, multicenter, randomized controlled trial evaluated the safety and efficacy of the sodium-glucose cotransporter-2 inhibitor dapagliflozin in patients with type 1 diabetes (T1D) not adequately controlled on insulin therapy. Patients were randomly assigned to receive dapagliflozin 5 mg or 10 mg, or placebo. The primary endpoint was A1C reduction from baseline. At 24 weeks, the mean A1C difference from baseline vs placebo was -0.42% and -0.45% for dapagliflozin 5 and 10 mg, respectively (P<0.0001 for both).