Publications by authors named "Stefano Prato"

Introduction: Previous studies have suggested an association between beta-cell and autonomic function and metabolic-associated fatty liver disease (MAFLD). We explored the association between controlled attenuated parameter (CAP) and insulin secretion and action, as well as sympathetic and parasympathetic activity in normal (NGT) and impaired (IGT) glucose tolerance.

Research Design And Methods: Twenty-five NGT (age 44.

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Article Synopsis
  • - Atrial fibrillation (AF) is more common in patients with type 2 diabetes and is linked to worse health outcomes; a trial called Harmony Outcomes was conducted to study the effects of albiglutide, a GLP-1 receptor agonist, on cardiovascular events in these patients.
  • - The trial included nearly 9,500 participants over 1.6 years and found that those with a history of AF had a higher rate of major adverse cardiac events, but albiglutide treatment reduced these events regardless of AF history.
  • - Although both groups on albiglutide experienced fewer AF events than those receiving a placebo, the reduction wasn't statistically significant, indicating that albiglutide can lower cardiovascular risks without
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Aims: To estimate the incidence of major adverse cardiovascular events (MACE), expanded MACE, and MACE or Death across Fibrosis- 4 score (FIB-4) categories in people with type 2 diabetes and to determine whether efpeglenatide's effect varies with increasing FIB-4 severity.

Materials And Methods: AMPLITUDE-O trial data were used to estimate the relationship of FIB-4 score categories to the hazard of MACE, expanded MACE, and MACE or death. Interactions on these outcomes between baseline FIB-4 score, and between FIB-4 score and efpeglenatide were also assessed.

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Background: Insulin efsitora alfa (efsitora) is a new basal insulin designed for once-weekly administration. Data on safety and efficacy have been limited to small, phase 1 or phase 2 trials.

Methods: We conducted a 52-week, phase 3, parallel-design, open-label, treat-to-target trial involving adults with type 2 diabetes who had not previously received insulin.

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Aims/hypothesis: We compared the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) on renal outcomes in individuals with type 2 diabetes, focusing on the changes in eGFR and albuminuria.

Methods: This was a multicentre retrospective observational study on new users of diabetes medications. Participant characteristics were assessed before and after propensity score matching.

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Introduction: Persons with diabetes are at risk for developing a cardiomyopathy through several pathophysiological mechanisms independent of traditional risk factors for heart failure. Among those with diabetic cardiomyopathy (DbCM), the relationship between natriuretic peptides, cardiac structural abnormalities and functional capacity is largely unknown.

Methods: In this prespecified subgroup analysis of the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial, 685 participants with asymptomatic DbCM underwent baseline echocardiography data, laboratory investigations, and functional assessments.

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Introdroduction: Obesity and its associated metabolic conditions have become a significant global health problem in recent years, with many people living with obesity fulfilling criteria for pharmacological treatment. The development of the glucagon-like peptide-1 receptor agonists for chronic weight management has triggered new interest in the incretins and other hormones as targets for obesity, and investigations into dual and triple co-agonists.

Methods: The objective of this narrative review was to summarize the available data on approved and emerging incretin-based agents for the treatment of obesity.

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Background: Diabetic cardiomyopathy (DbCM) increases risk of overt heart failure in individuals with diabetes mellitus. Racial and ethnic differences in DbCM remain unexplored.

Objectives: The authors sought to identify racial and ethnic differences among individuals with type 2 diabetes mellitus, structural heart disease, and impaired exercise capacity.

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Aims: To assess the cost-utility of the FreeStyle Libre flash continuous glucose monitoring (CGM) system from an Italian healthcare system perspective, when compared with self-monitoring of blood glucose (SMBG) in people living with type 2 diabetes mellitus (T2DM) receiving basal insulin.

Materials And Methods: A patient-level microsimulation model was run using Microsoft Excel for 10 000 patients over a lifetime horizon, with 3.0% discounting for costs and utilities.

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Article Synopsis
  • The spectrum of cardiorenal and metabolic diseases includes various disorders like obesity, type 2 diabetes, chronic kidney disease, and heart failure, often co-existing in the same patient due to shared physiological pathways.
  • Recent trials have shown that treatments can benefit multiple conditions simultaneously, highlighting a need for updated clinical guidance.
  • An international task force of specialists has created the DCRM 2.0 Practice Recommendations, which consist of 22 graphics to help clinicians manage these complex conditions effectively, aiming to enhance patient health and outcomes.
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  • * New treatment options, like dual GLP-1 and GIP receptor agonists, are being developed to combat this rise, with tirzepatide being a prominent example.
  • * This document reviews the main ways that GIP/GLP-1 co-agonists work and discusses the clinical effects of tirzepatide based on various studies.
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The COVID-19 pandemic has caused major disruptions in clinical services for people with chronic long-term conditions. In this narrative review, we assess the indirect impacts of the COVID-19 pandemic on diabetes services globally and the resulting adverse effects on rates of diagnosing, monitoring, and prescribing in people with type 2 diabetes. We summarise potential practical approaches that could address these issues and improve clinical services and outcomes for people living with diabetes during the recovery phase of the pandemic.

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Article Synopsis
  • Despite decreasing overall risks of heart disease, people with type 2 diabetes are still facing high rates of cardiovascular issues, making early and intensive treatment crucial.
  • Multiple factors contribute to heart disease risk in diabetes, highlighting the need for a comprehensive prevention approach.
  • New diabetes medications like SGLT2 inhibitors and GLP-1 receptor agonists show promise not only in controlling blood sugar but also in significantly reducing the risk of serious heart-related events.
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Objective: To explore the complementary effects of a combination of dipeptidyl peptidase 4 and sodium-glucose cotransporter 2 inhibitors added to metformin on hormonal and metabolic responses to meal ingestion.

Research Design And Methods: Forty-five patients (age 58 ± 8 years; HbA1c 58 ± 6 mmol/mol; BMI 30.7 ± 3.

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Background: Progression to symptomatic heart failure is a complication of type 2 diabetes; heart failure onset in this setting is commonly preceded by deterioration in exercise capacity.

Objectives: This study sought to determine whether AT-001, a highly selective aldose reductase inhibitor, can stabilize exercise capacity among individuals with diabetic cardiomyopathy (DbCM) and reduced peak oxygen uptake (Vo).

Methods: A total of 691 individuals with DbCM meeting inclusion and exclusion criteria were randomized to receive placebo or ascending doses of AT-001 twice daily.

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Although continuous glucose monitoring (CGM) devices are now considered the standard of care for people with type 1 diabetes mellitus, the uptake among people with type 2 diabetes mellitus (T2DM) has been slower and is focused on those receiving intensive insulin therapy. However, increasing evidence now supports the inclusion of CGM in the routine care of people with T2DM who are on basal insulin-only regimens or are managed with other medications. Expanding CGM to these groups could minimize hypoglycaemia while allowing efficient adaptation and escalation of therapies.

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Background: Non-alcoholic fatty liver disease (NAFLD), identified by the Fatty Liver Index (FLI), is associated with increased mortality and cardiovascular (CV) outcomes. Whether this also applies to type 1 diabetes (T1D) has not been yet reported.

Methods: We prospectively observed 774 subjects with type 1 diabetes (males 52%, 30.

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  • Dapagliflozin, a medication for type 2 diabetes (T2D), was found to better preserve kidney function and reduce albuminuria compared to other diabetes treatments over a 2.5-year follow-up.
  • In a study involving nearly 12,000 matched patients, those using dapagliflozin experienced less decline in estimated glomerular filtration rate (eGFR) and showed significant reductions in albumin levels within 6 months.
  • The findings suggest dapagliflozin may lower the risk of developing chronic kidney disease (CKD) in T2D patients with low initial kidney risk, making it a beneficial treatment option.
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Aim: To analyse the effects of albiglutide, a glucagon-like peptide 1 receptor agonist, on cardiovascular outcomes in older adults aged ≥65 years with type 2 diabetes and cardiovascular disease who participated in the Harmony Outcomes trial (NCT02465515).

Materials And Methods: We conducted a post hoc analysis of the primary endpoint of the Harmony Outcomes trial-time to first occurrence of a major adverse cardiovascular event-in subgroups of participants aged <65 and ≥65 years and <75 and ≥75 years at baseline. Hazard ratios and 95% confidence intervals (CIs) were generated using Cox proportional hazards regression.

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Background: Diabetic cardiomyopathy (DbCM) is a form of Stage B heart failure (HF) at high risk for progression to overt disease. Using baseline characteristics of study participants from the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) Trial we sought to characterize clinical characteristics of individuals with findings consistent with DbCM.

Methods: Among study participants meeting inclusion criteria, clinical characteristics, laboratory testing, imaging, Kansas City Cardiomyopathy Questionnaire (KCCQ), Physical Activity Scale of the Elderly (PASE) and cardiopulmonary exercise testing (CPET) results were tabulated.

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Aims: Large outcome trials have demonstrated cardiovascular benefits of selected glucagon-like peptide-1 (GLP-1) receptor agonists. We examined coronary disease outcomes in the Harmony Outcomes trial of the GLP-1 receptor agonist albiglutide.

Methods And Results: Harmony Outcomes was an event-driven, multicenter, double-blind, and placebo-controlled trial involving 9463 patients >40 years of age with type-2 diabetes and established atherosclerotic cardiovascular disease.

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