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Update on Diabetes Medical Management: Epidemiology and Treatment

  • Lila S. Chertman
  • Danielle Neuman
  • Francesco VendrameEmail author
Chapter

Abstract

Diabetes represents a group of metabolic disorders which is affecting a growing number of people. It is estimated that worldwide about 8.8% of the adult population have diabetes and another 7% has prediabetes. Type 2 diabetes is the most common form and accounts for about 90–95% of cases. Diabetes in most developed countries is the leading cause of cardiovascular disease, adult-onset blindness, kidney failure, and lower-limb amputation. The goal of diabetes treatment is the prevention of diabetes emergencies and prevention of complications. Diabetes emergencies for type 1 and type 2 diabetes include diabetes ketoacidosis and the hyperosmolar hyperglycemic state, respectively. Long-term complications of hyperglycemia include microvascular complications such as retinopathy, nephropathy, neuropathy, and macrovascular complications which include coronary artery disease, peripheral artery disease, and cerebrovascular disease. While treatment for type 1 diabetes mostly relies on insulin treatment, for patients with type 2 diabetes, there are now medications which have been shown to have also beneficial cardiovascular effects. We are therefore moving to a new era where in addition to glucose control it is now also possible to target the cardiovascular system. It is crucial that patients acquire awareness of diabetes and its complications since this is often poorly appreciated. This chapter will focus on the current epidemiology and treatment of type 1 and type 2 diabetes in adults.

Keywords

Diabetes epidemiology Diabetes treatment Insulin therapy Antidiabetic medications 

References

  1. American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37(Supplement 1), S81–S90.  https://doi.org/10.2337/dc14-S081CrossRefGoogle Scholar
  2. American Diabetes Association. (2018). Classification and diagnosis of diabetes: Standards of medical Care in Diabetes. Diabetes Care, 41(Suppl 1), S13–s27.  https://doi.org/10.2337/dc18-S002CrossRefGoogle Scholar
  3. Bergenstal, R. M., Garg, S., Weinzimer, S. A., … Kaufman, F. R. (2016). Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. JAMA, 316(13), 1407–1408.  https://doi.org/10.1001/jama.2016.11708CrossRefPubMedGoogle Scholar
  4. Buzzetti, R., Pozzilli, P., Frederich, R., Iqbal, N., & Hirshberg, B. (2016). Saxagliptin improves glycaemic control and C-peptide secretion in latent autoimmune diabetes in adults (LADA). Diabetes/Metabolism Research and Reviews, 32(3), 289–296.  https://doi.org/10.1002/dmrr.2717CrossRefPubMedGoogle Scholar
  5. Center for Disease Control and Prevention. (2017). National diabetes statistics report, 2017. Retrieved from https://www.cdc.gov/diabetes/data/statistics/statistics-report.html
  6. Defronzo, R. A. (2009). Banting lecture. From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes, 58(4), 773–795.  https://doi.org/10.2337/db09-9028CrossRefPubMedPubMedCentralGoogle Scholar
  7. DeFronzo, R. A., Hompesch, M., Kasichayanula, S., Liu, X., Hong, Y., Pfister, M., … Griffen, S. C. (2013). Characterization of renal glucose reabsorption in response to dapagliflozin in healthy subjects and subjects with type 2 diabetes. Diabetes Care, 36(10), 3169–3176.  https://doi.org/10.2337/dc13-0387CrossRefPubMedPubMedCentralGoogle Scholar
  8. Diabetes Control and Complications Trial Research Group. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine, 329(14), 977–986.  https://doi.org/10.1056/nejm199309303291401CrossRefGoogle Scholar
  9. Diabetes Control and Complications Trial Research Group. (2016). Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: The DCCT/EDIC study 30-year follow-up. Diabetes Care, 39(5), 686–693.  https://doi.org/10.2337/dc15-1990CrossRefGoogle Scholar
  10. Diaz-Valencia, P. A., Bougnères, P., & Valleron, A.-J. (2015). Global epidemiology of type 1 diabetes in young adults and adults: A systematic review. BMC Public Health, 15(1), 255.  https://doi.org/10.1186/s12889-015-1591-yCrossRefPubMedPubMedCentralGoogle Scholar
  11. Elgart, J. F., Gonzalez, L., Prestes, M., Rucci, E., & Gagliardino, J. J. (2016). Frequency of self-monitoring blood glucose and attainment of HbA1c target values. Acta Diabetologica, 53(1), 57–62.  https://doi.org/10.1007/s00592-015-0745-9CrossRefPubMedGoogle Scholar
  12. Gorham, E. D., Barrett-Connor, E., Highfill-McRoy, R. M., Mohr, S. B., Garland, C. F., Garland, F. C., & Ricordi, C. (2009). Incidence of insulin-requiring diabetes in the US military. Diabetologia, 52(10), 2087–2091.  https://doi.org/10.1007/s00125-009-1449-xCrossRefPubMedPubMedCentralGoogle Scholar
  13. Grunberger, G., Abelseth, J. M., Bailey, T. S., Bode, B. W., Handelsman, Y., Hellman, R., … Rothermel, C. (2014). Consensus statement by the American Association of Clinical Endocrinologists/American College of Endocrinology insulin pump management task force. Endocrine Practice, 20(5), 463–489.  https://doi.org/10.4158/ep14145.psCrossRefPubMedGoogle Scholar
  14. Heinemann, L., Home, P. D., & Hompesch, M. (2015). Biosimilar insulins: Guidance for data interpretation by clinicians and users. Diabetes Obesity & Metabolism, 17(10), 911–918.  https://doi.org/10.1111/dom.12491CrossRefGoogle Scholar
  15. Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008). 10-year follow-up of intensive glucose control in type 2 diabetes. New England Journal of Medicine, 359(15), 1577–1589.  https://doi.org/10.1056/NEJMoa0806470CrossRefPubMedGoogle Scholar
  16. International. (2017). IDF diabetes atlas 7. Retrieved from http://www.diabetesatlas.org/
  17. Johansen, O. E., Boehm, B. O., Grill, V., Torjesen, P. A., Bhattacharya, S., Patel, S., & Woerle, H. J. (2014). C-peptide levels in latent autoimmune diabetes in adults treated with linagliptin versus glimepiride: Exploratory results from a 2-year double-blind, randomized, controlled study. Diabetes Care, 37(1), e11–e12.  https://doi.org/10.2337/dc13-1523CrossRefPubMedGoogle Scholar
  18. Katsarou, A., Gudbjornsdottir, S., Rawshani, A., Dabelea, D., Bonifacio, E., Anderson, B. J., & Lernmark, A. (2017). Type 1 diabetes mellitus. Nat Rev Dis Primers, 3, 17016.  https://doi.org/10.1038/nrdp.2017.16CrossRefPubMedGoogle Scholar
  19. Lamos, E. M., Younk, L. M., & Davis, S. N. (2016). Concentrated insulins: The new basal insulins. Therapeutics and Clinical Risk Management, 12, 389–400.  https://doi.org/10.2147/TCRM.S99855CrossRefPubMedPubMedCentralGoogle Scholar
  20. Landstedt-Hallin, L., Arner, P., Lins, P. E., Bolinder, J., Olsen, H., & Groop, L. (1999). The role of sulphonylurea in combination therapy assessed in a trial of sulphonylurea withdrawal. Scandinavian insulin-Sulphonylurea study group research team. Diabetic Medicine, 16(10), 827–834.CrossRefGoogle Scholar
  21. Laugesen, E., Østergaard, J. A., & Leslie, R. D. G. (2015). Latent autoimmune diabetes of the adult: Current knowledge and uncertainty. Diabetic Medicine, 32(7), 843–852.  https://doi.org/10.1111/dme.12700CrossRefPubMedPubMedCentralGoogle Scholar
  22. Lind, M., Polonsky, W., Hirsch, I. B., … Hellman, J. (2017). Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: The gold randomized clinical trial. JAMA, 317(4), 379–387.  https://doi.org/10.1001/jama.2016.19976CrossRefPubMedGoogle Scholar
  23. Malanda, U. L., Welschen, L. M., Riphagen, I. I., Dekker, J. M., Nijpels, G., & Bot, S. D. (2012). Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database of Systematic Reviews, 1, Cd005060.  https://doi.org/10.1002/14651858.CD005060.pub3CrossRefPubMedGoogle Scholar
  24. Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., … Buse, J. B. (2016). Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine, 375(4), 311–322.  https://doi.org/10.1056/NEJMoa1603827CrossRefPubMedGoogle Scholar
  25. Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., … Tamborlane, W. V. (2015). Current state of type 1 diabetes treatment in the U.S.: Updated data from the T1D exchange clinic registry. Diabetes Care, 38(6), 971–978.  https://doi.org/10.2337/dc15-0078CrossRefPubMedGoogle Scholar
  26. Moy, C. S., Songer, T. J., LaPorte, R. E., Dorman, J. S., Kriska, A. M., Orchard, T. J., … Drash, A. L. (1993). Insulin-dependent diabetes mellitus, physical activity, and death. American Journal of Epidemiology, 137(1), 74–81.CrossRefGoogle Scholar
  27. Nauck, M. A., Baller, B., & Meier, J. J. (2004). Gastric inhibitory polypeptide and glucagon-like peptide-1 in the pathogenesis of type 2 diabetes. Diabetes, 53(Suppl 3), S190–S196.CrossRefGoogle Scholar
  28. Pi-Sunyer, X. (2014). The look AHEAD trial: A review and discussion of its outcomes. Curr Nutr Rep, 3(4), 387–391.  https://doi.org/10.1007/s13668-014-0099-xCrossRefPubMedPubMedCentralGoogle Scholar
  29. Pratley, R. E. (2016). Should GLP-1 receptor agonists be the first line of treatment for type 2 diabetes? Diabetes Technology & Therapeutics, 18(11), 671–673.  https://doi.org/10.1089/dia.2016.0339CrossRefGoogle Scholar
  30. Ratner, R. E., Dickey, R., Fineman, M., Maggs, D. G., Shen, L., Strobel, S. A., … Kolterman, O. G. (2004). Amylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight control in type 1 diabetes mellitus: A 1-year, randomized controlled trial. Diabetic Medicine, 21(11), 1204–1212.  https://doi.org/10.1111/j.1464-5491.2004.01319.xCrossRefPubMedGoogle Scholar
  31. Ruedy, K. J., Parkin, C. G., Riddlesworth, T. D., & Graham, C. (2017). Continuous glucose monitoring in older adults with type 1 and type 2 diabetes using multiple daily injections of insulin: Results from the DIAMOND trial. Journal of Diabetes Science and Technology, 1932296817704445.  https://doi.org/10.1177/1932296817704445CrossRefGoogle Scholar
  32. Skyler, J. S., Bergenstal, R., Bonow, R. O., Buse, J., Deedwania, P., Gale, E. A. M., … Sherwin, R. S. (2009). Intensive glycemic control and the prevention of cardiovascular events: Implications of the ACCORD, ADVANCE, and VA diabetes trials. A position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association, 32(1), 187–192.  https://doi.org/10.2337/dc08-9026CrossRefGoogle Scholar
  33. UKPDS Group. (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK prospective diabetes study (UKPDS) group. Lancet, 352(9131), 837–853.CrossRefGoogle Scholar
  34. Vella, S., Buetow, L., Royle, P., Livingstone, S., Colhoun, H. M., & Petrie, J. R. (2010). The use of metformin in type 1 diabetes: A systematic review of efficacy. Diabetologia, 53(5), 809–820.  https://doi.org/10.1007/s00125-009-1636-9CrossRefPubMedGoogle Scholar
  35. Vendrame, F., Hopfner, Y. Y., Diamantopoulos, S., Virdi, S. K., Allende, G., Snowhite, I. V., … Pugliese, A. (2016). Risk factors for type 1 diabetes recurrence in immunosuppressed recipients of simultaneous pancreas-kidney transplants. American Journal of Transplantation, 16(1), 235–245.  https://doi.org/10.1111/ajt.13426CrossRefPubMedGoogle Scholar
  36. Wing, R. R., Bolin, P., Brancati, F. L., Bray, G. A., Clark, J. M., Coday, M., … Yanovski, S. Z. (2013). Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. The New England Journal of Medicine, 369(2), 145–154.  https://doi.org/10.1056/NEJMoa1212914CrossRefPubMedGoogle Scholar
  37. Whalen, K., Miller, S., & Onge, E. S. (2015). The role of sodium-glucose co-transporter 2 inhibitors in the treatment of type 2 diabetes. Clinical Therapeutics, 37(6), 1150–1166.  https://doi.org/10.1016/j.clinthera.2015.03.004CrossRefPubMedGoogle Scholar
  38. Whitehouse, F., Kruger, D. F., Fineman, M., Shen, L., Ruggles, J. A., Maggs, D. G., … Kolterman, O. G. (2002). A randomized study and open-label extension evaluating the long-term efficacy of pramlintide as an adjunct to insulin therapy in type 1 diabetes. Diabetes Care, 25(4), 724–730.CrossRefGoogle Scholar
  39. Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., … Inzucchi, S. E. (2015). Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. New England Journal of Medicine, 373(22), 2117–2128.  https://doi.org/10.1056/NEJMoa1504720CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Lila S. Chertman
    • 1
  • Danielle Neuman
    • 2
  • Francesco Vendrame
    • 1
    Email author
  1. 1.Division of Endocrinology, Diabetes and Metabolism, Department of MedicineUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Division of Internal Medicine, Department of MedicineUniversity of Miami Miller School of Medicine/Jackson Memorial HospitalMiamiUSA

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