Canadian Real-World Outcomes of Omnipod Initiation in People with Type 1 Diabetes (COPPER study): Evidence from the LMC Diabetes Registry
Managing intensive insulin therapy with continuous subcutaneous insulin infusion (CSII) or pump therapy has been associated with improved glycaemic control and quality of life with less severe hypoglycaemia than is associated with multiple daily injections (MDI). This study is the first to report on real-world clinical outcomes of adults with type 1 diabetes who initiated the Omnipod Insulin Management System compared to a matched cohort of MDI therapy users. The study demonstrated that adults with type 1 diabetes who switched from MDI to Omnipod therapy in real-world clinical practice experienced an improvement in HbA1c, with no increase in weight, and had a significant reduction in total daily dose of insulin.
Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database
Goal achievement of HbA1c and LDL-cholestrol in a randomized trial comparing colesevelam with exetimibe: GOAL-RCT
Despite the widespread availability, efficacy and cost benefit of statins, a care gap persists in achieving recommended LDL-c targets at a population level. GOAL-RCT is the first randomized controlled trial comparing ezetimibe and colesevelam in subjects with type 2 diabetes. The primary composite endpoint of LDL-c and HbA1c target attainment was similar among the two groups (14.6% of patients in the colesevelam arm and 10.5% of patients in the ezetimibe arm). However, initiation of ezetimibe led to a greater reduction in LDL-c, and a significantly higher proportion of subjects achieving target LDL-c levels, compared with colesevelam. This study suggests favourable LDL-c reduction, tolerability and therapy persistence for ezetimibe compared with colesevelam in T2D.
Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database
Flexible insulin therapy with a hybrid regimen of insulin degludec and continuous subcutaneous insulin infusion with pump suspension before exercise in physically active adults with type 1 diabetes (FIT Untethered): a single-centre, open-label, proof-of-concept, randomized crossover trial.
A common practice among active individuals with type 1 diabetes is to suspend or fully disconnect their insulin pump before exercise for convenience and to avoid hypoglycaemia. FIT Untethered is the first study to provide evidence that a hybrid approach of using a split provision of basal insulin by combining 50% CSII with 50% basal insulin degludec injection is safe and effective for exercise sessions. This hybrid insulin delivery approach allows pump removal during exercise while increasing time in blood glucose range of 4–10 mmol/L following brief high-intensity exercise and extended moderate intensity exercise, without reducing overall glycaemic control or increasing patient burden. These findings suggest that people with type 1 diabetes have additional options to help maintain, or even improve, glycaemic control while living an active life.
Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database
The Canadian LMC Diabetes Registry: A Profile of the Demographics, Management, and Outcomes of Individuals with Type 1 Diabetes
Clinical guidelines now define the standard of diabetes care, but few health care jurisdictions systematically assess their practicality and impact. An accurate and constant awareness of the clinical status of people with type 1 diabetes is necessary to inform the feasibility of current guidelines and the need for future strategy redevelopment. This study was able to leverage the Canadian LMC Diabetes Registry that includes the electronic health records of >50 endocrinologists in three provinces and provides quarterly real-time outcome reports to each endocrinologist. This study determined that the majority of adults with type 1 diabetes did not meet metabolic targets outlined by the American Diabetes Association and Diabetes Canada.
Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database
Semaglutide once weekly in people with type 2 diabetes: Real-world analysis of the Canadian LMC diabetes registry (SPARE study)
Semaglutide has been shown to have high efficacy as a treatment for patients with type 2 diabetes (T2D). Although the clinical trials show promising results, it is difficult for them to accurately represent a real-world population. The SPARE study leveraged the LMC Diabetes Registry to assess the real-world outcomes of patients with T2D using semaglutide once weekly. The study concluded that the sample showed clinically and statistically significant reductions in HbA1c, weight, blood pressure and lipids with no significant hypoglycemia. The findings of this study strengthen the research available on semaglutide and suggest that semaglutide can be an effective treatment for the management of T2D in the real world.
Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database
Prevalence and Risk Evaluation of Diabetic Complications of the Foot Among Adults with Type 1 and Type 2 Diabetes in a Large Canadian Population (PEDAL Study)
Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database