Publications by authors named "Alice Y Cheng"

Stroke is a major cause of death and long-term disability worldwide. Diabetes is associated with an increased risk of cardiovascular complications, including stroke. People with diabetes have a 1.

View Article and Find Full Text PDF

Aim: To conduct an adjusted indirect treatment comparison (aITC) of the efficacy of tirzepatide 5/10/15 mg versus semaglutide 2 mg in patients with type 2 diabetes.

Materials And Methods: The primary analysis was a Bucher aITC of the change from baseline at week 40 in HbA1c (%) and body weight (kg). Aggregate data from the SURPASS-2 study that met the HbA1c inclusion criterion of the SUSTAIN FORTE study and from SUSTAIN FORTE metformin-only treated patients were used for primary analysis.

View Article and Find Full Text PDF

Diabetes is a progressive disease associated with micro- and macrovascular complications. Type 2 diabetes (T2D) is the leading contributor to chronic kidney disease (CKD) worldwide, which itself is associated with an increased burden of cardiovascular disease, increased risk of hypoglycemia, and increased risk of death beyond that caused by diabetes alone. In this video series available on The Journal of Family Practice website, the authors discuss how CKD in people with T2D is defined, potential consequences of CKD in this patient population, and how those with CKD and T2D should be identified, monitored, and treated.

View Article and Find Full Text PDF

A sea change in the management of diabetes is occurring with the publication of clinical trials showing unequivocal cardiovascular (CV) protection through the use of certain antihyperglycemic agents. This change is similar to the change that occurred when lipid lowering with statins was first shown to have CV benefits, an event necessitating changes in training and the proactive treatment of lipids by CV specialists. As was the case then, many CV specialists currently feel poorly equipped to address diabetes with this new information even though diabetes is common in CV practice.

View Article and Find Full Text PDF

Diabetes mellitus (DM), a chronic metabolic disease characterized by hyperglycemia, is a profound cardiovascular (CV) risk factor. It compounds the effects of all other risk factors, leads to premature micro- and macrovascular disease, facilitates development of heart failure, worsens the clinical course of all CV diseases, and shortens life expectancy. Established DM, unrecognized DM, and dysglycemia that may progress to DM are all commonly present at the time of presentation of overt CV disease.

View Article and Find Full Text PDF

Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly.

View Article and Find Full Text PDF

Objective: To gain insight into the current management of patients with type 2 diabetes mellitus by Canadian primary care physicians.

Method: A total of 479 primary care physicians from across Canada submitted data on 5123 type 2 diabetes patients whom they had seen on a single day on or around World Diabetes Day, November 14, 2012.

Results: Mean glycated hemoglobin (A1C) was 7.

View Article and Find Full Text PDF

The primary objective of the current study was to examine the extent to which domain-specific time perspective predicts weight management behaviors (dietary behavior and physical activity) among those newly diagnosed with Type 2 diabetes. A secondary objective was to test potential mediators of the hypothesized effect (behavioral intention, self-efficacy and control beliefs). A total of 204 adults newly diagnosed (≤6 months) with Type 2 diabetes participated in the study, which included a baseline assessment of domain-general and domain-specific time perspective, as well as strength of intention to perform two weight-management behaviors (dietary choice and physical activity); both weight-management behaviors were assessed again at 6 month follow-up.

View Article and Find Full Text PDF

For the reduction of microvascular complications in type 2 diabetes, glycemic control has been shown to be an important and effective intervention. However, considering the findings from several recent, large, randomized controlled trials, the utility of very tight glycemic control in all those with type 2 diabetes, for the reduction of cardiovascular disease remains controversial. The decision to aim for very tight glycemic control must be individualized and the potential benefit of reduced risk of nephropathy must be weighed against the increased risk for hypoglycemia.

View Article and Find Full Text PDF

Clinical practice guidelines from around the world have continued to highlight the importance of glycemic control in the prevention of diabetes complications. Despite the many tools available to achieve these targets, it remains a constant challenge for healthcare providers and patients alike. Rosiglitazone maleate + metformin hydrochloride extend is a new compound that has the advantage of the clinical experience and knowledge about the current version and the added benefit of being a once daily, single pill option.

View Article and Find Full Text PDF

Over the past decade, clinical practice guidelines have lowered their glycemic targets for people with type 2 diabetes. However, recent randomized controlled trials (ACCORD, ADVANCE, and VADT) demonstrate that intensive glycemic targets do not reduce cardiovascular risk among higher-risk individuals over a period of 3.5 to 5 years.

View Article and Find Full Text PDF

Among individuals with diabetes mellitus, cardiovascular disease remains the leading cause of death, despite the many treatment modalities that have been developed over time. The PPAR family, including PPAR-alpha, play important roles in glucose and lipid metabolism and atherosclerosis and thus are potential therapeutic targets. Fibrates act upon PPAR-alpha and appear to target the typical dyslipidaemia of diabetes.

View Article and Find Full Text PDF