A retrospective cohort analysis assessed the impact of a change in primary care model on diabetes outcomes among patients receiving care at seven Midwestern Veterans Affairs facilities.
Patients with diabetes who were taking any beta-blocker, a beta-1 selective beta-blocker, or a specific beta-blocker had significantly higher risk for all-cause mortality versus patients with diabetes who were not taking a beta-blocker.
The retrospective study at a single tertiary care referral medical center compared cost-effectiveness of care from a specialized diabetes team with care from a primary service team.
The system is the first approved to be used with other diabetes devices, such as automated insulin-dosing systems, insulin pumps, or blood glucose meters, according to the FDA.
Review: Adding a DPP-4 inhibitor to an SGLT-2 inhibitor reduces genital, but not genitourinary, tract infections
The authors of an accompanying ACP Journal Club commentary noted that although the risk for bias in the five reviewed studies was reportedly low, the results were imprecise and inconsistent, leaving little confidence in the evidence of an apparent reduction in infection risk with dipeptidyl peptidase-4 (DPP-4) inhibitors.
The author of an ACP Journal Club commentary said that the intervention effect was strong enough to prompt a reconsideration of primary care management of obesity and that the results of the trial may motivate patients to lose enough weight to reverse diabetes.
ICU patients who were given insulin only when glucose exceeded 14 mmol/L (>252 mg/dL) had slightly less hypoglycemia and similar creatinine levels, white cell counts, and mortality rates versus those treated with insulin when glucose exceeded 10 mmol/L (>180 mg/dL).