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This month, in honor of National Diabetes Month, our focus is on research that examines the impact of diabetes in Veterans.
Diabetes affects nearly 25 percent of Veterans who seek care from VA. For these people, it is the leading cause of blindness, end-stage renal disease, and amputation. VA researchers are studying innovative strategies to improve the lives of Veterans who have diabetes. Innovations in care include group visits, telemedicine, peer counseling, and Internet-based education and case management. Researchers are also working to develop better ways to prevent or treat diabetes, particularly in special populations such as the elderly and patients with spinal cord injury.
Routine blood tests could predict future diabetes
Researchers from three VA health care systems showed that elevated blood glucose levels detected in routine outpatient tests, though well below diagnostic thresholds, predicted diabetes diagnoses within five years. ... (07/19/2019)
VA Diabetes Trial
VA researchers have published long-term follow-up results (15 years) from a major diabetes trial, in which patients saw no significant drop, on average, in heart attacks or strokes. Following initial intensive therapy to lower blood sugar levels, patients at the 10-year follow-up did have a lower incidence of heart disease. Researchers suggest that patients must sustain good blood sugar levels in order to keep health benefits. (06/27/2019)
Study: Patients with diabetes do as well with physician assistants, nurse practitioners as with physicians
VA patients with diabetes have similar health outcomes regardless of whether their primary provider is a physician, nurse practitioner, or physician assistant, according to a Durham VA Health Care System study.... (06/04/2019)
Gene transfer improves diabetes-linked heart ailment
Researchers with VA and the University of California San Diego have shown that a gene transfer technique can combat heart dysfunction caused by diabetes.... (03/27/2019)
VA study links antibiotics with diabetes risk
A study from the VA New York Harbor Healthcare System found that Veterans with a history of antibiotic use were more likely to develop Type 2 diabetes.... (02/14/2019)
Study: Online program helps Veterans lose weight, potentially prevent diabetes
VA researchers compared an online version of the Diabetes Prevention Program to an in-person DPP and to MOVE!, VA's flagship weight management program.... (02/05/2019)
Dr. W. Timothy Garvey’s lab team in Birmingham is in hot pursuit of a new diabetes drug that will keep the disease from progressing. One lead they are pursuing is a gene known as TRIB3, shown to be a major driver of insulin resistance. ... (04/04/2018)
Many patients show signs of chronic kidney disease before diabetes diagnosis
Many patients who will later be diagnosed with diabetes show signs of chronic kidney disease even before their diabetes diagnosis, according to a study by VA researchers and colleagues in Tennessee.... (03/13/2018)
Dr. Sol Solomon (01/12/18)
Memphis VA Medical Center
Main area of study: Diabetes
"When the Air Force told me I'd be stationed at Ramstein outside of Munich, Germany, I declined because the entire Polish side of my family had perished in the Nazi concentration camp at Auschwitz."
Diabetes and Alzheimer’s risk factors together linked to greater cognitive decline
Patients with both diabetes and Alzheimer’s disease risk factors showed greater cognitive decline than those with one or the other, in a VA San Diego Healthcare System study. Researchers followed the cognitive functioning of patients for five years. Patients with both diabetes and at least one Alzheimer’s risk factor showed the most cognitive decline, greater than those with only diabetes, only Alzheimer’s risk factors, or neither. Alzheimer’s risk factors included subtle cognitive decline, genetic risk, and three biomarkers found in the spinal fluid. The results suggest that diabetes interacts with Alzheimer’s risk factors to increase cognitive decline, according to the researchers. (Alzheimer’s Disease and Associated Disorders, July 10, 2019)
Care cost lower for diabetes patients primarily seeing NPs or PAs rather than physicians
Use of nurse practitioners and physician assistants could lead to lower health care costs for diabetes care, according to a Durham VA Health Care System study. Researchers looked at a year of VA data on medically complex patients with diabetes. They found that patients whose primary care provider was a nurse practitioner or physician assistant had 6–7% lower average total care costs than patients with a physician as the primary care provider. The difference was mainly due to more use of emergency and inpatients services by the physician group. The study suggests that nurse practitioners and physician assistants can effectively manage primary care for complex patients with diabetes without increasing care costs. (Health Affairs, June 2019)
Newer hepatitis C drugs pose advantage for diabetes risk
Hepatitis C patients treated with directly acting antiviral agents had lower risk of diabetes than patients treated with interferon, in a VA Pittsburgh Healthcare System study. Hepatitis C infection is linked to higher risk of diabetes. Results from previous research were mixed on whether treatment with interferon—an older treatment for hepatitis C—affects diabetes risk. To test how newer directly acting antiviral agent treatment affects diabetes risk, researchers studied data on more than 240,000 people with chronic hepatitis C. For both untreated patients and patients treated with interferon, about 2% developed diabetes. Only 0.1% of patients treated with directly acting antiviral agents developed diabetes after treatment. Patients with more advanced liver fibrosis had even larger diabetes risk reduction. The results show that the new antiviral agents may be better than older treatments at controlling hepatitis C complications, say the researchers. (Clinical Infectious Diseases, April 12, 2019)
Diabetes drug equally effective across groups
The diabetes medication empagliflozin reduces blood sugar levels for people with diabetes across a variety of demographics, found a VA Palo Alto Health Care System. Empagliflozin, sold as Jardiance, is a medication for reducing A1c (blood glucose) levels. Researchers looked at data on nearly 8,000 VA patients with Type 2 diabetes taking the drug. They found patients had an average of 0.7% reduction in A1c levels after six months on empagliflozin. Black and white patients had similar A1c reductions. Those with and without cardiovascular disease also had similar reductions. Patients with the highest A1c levels at baseline had the largest A1c reductions after six months. Patients also taking insulin had lower A1c reductions than those not taking insulin. (American Diabetes Association, June 9, 2019)
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Updated/Reviewed: Nov. 12, 2019