Background: The management of diabetes-related complications accounts for a large share of total carbon dioxide equivalent (COe) emissions. We assessed whether improving diabetes control in people with type 2 diabetes reduces COe emissions, compared with those with unchanging glycemic control.
Methods: Using the IQVIA Core Diabetes Model, we estimated the impact of maintaining glycated hemoglobin (HbA) at 7% (53 mmol/mol) or reducing it by 1% (11 mmol/mol) on total COe/patient and COe/life-year (LY). Two different cohorts were investigated: those on first-line medical therapy (cohort 1) and those on third-line therapy (cohort 2). COe was estimated using cost inputs converted to carbon inputs using the UK National Health Service's carbon intensity factor. The model was run over a 50-year time horizon, discounting total costs and quality adjusted life years (QALYs) up to 5% and COe at 0%.
Results: Maintaining HbA at 7% (53 mmol/mol) reduced total COe/patient by 18% (1546 kgCOe/patient) vs 13% (937 kgCOe/patient) in cohorts 1 and 2, respectively, and led to a reduction in COe/LY gain of 15%-20%. Reducing HbA by 1% (11 mmol/mol) caused a 12% (cohort 1) and 9% (cohort 2) reduction in COe/patient with a COe/LY gain reduction of 11%-14%.
Conclusions: When comparing people with untreated diabetes, maintaining glycemic control at 7% (53 mmol/mol) on a single agent or improving HbA by 1% (11 mmol/mol) by the addition of more glucose-lowering treatment was associated with a reduction in carbon emissions.
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http://dx.doi.org/10.1136/bmjdrc-2019-001017 | DOI Listing |
Diabetologia
January 2025
MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Aims/hypothesis: UK standard care for type 2 diabetes is structured diabetes education, with no effects on HbA, small, short-term effects on weight and low uptake. We evaluated whether remotely delivered tailored diabetes education combined with commercial behavioural weight management is cost-effective compared with current standard care in helping people with type 2 diabetes to lower their blood glucose, lose weight, achieve remission and improve cardiovascular risk factors.
Methods: We conducted a pragmatic, randomised, parallel two-group trial.
Lancet Diabetes Endocrinol
January 2025
Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. Electronic address:
Background: About half of patients with heart failure with mildly reduced or preserved ejection fraction (HFpEF) have type 2 diabetes. In the STEP-HFpEF DM trial of adults with obesity-related HFpEF and type 2 diabetes, subcutaneous once weekly semaglutide 2·4 mg conferred improvements in heart failure-related symptoms and physical limitations, bodyweight, and other heart failure outcomes. We aimed to determine whether these effects of semaglutide differ according to baseline HbA.
View Article and Find Full Text PDFDiabetologia
January 2025
Internal Medicine Department, Endocrine Division (SEMPR), Universidade Federal do Paraná, Curitiba, Brazil.
Aims/hypothesis: COMBINE 2 assessed the efficacy and safety of once-weekly IcoSema (a combination therapy of basal insulin icodec and semaglutide) vs once-weekly semaglutide (a glucagon-like peptide-1 analogue) 1.0 mg in individuals with type 2 diabetes inadequately managed with GLP-1 receptor agonist (GLP-1 RA) therapy, with or without additional oral glucose-lowering medications.
Methods: This 52 week, randomised, multicentre, open-label, parallel group, Phase IIIa trial was conducted across 121 sites in 13 countries/regions.
Diabet Med
January 2025
Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark.
Aim: Time-restricted eating (TRE) limits the time for food intake to typically 6-10 h/day without other dietary restrictions. The aim of the RESET2 (the REStricted Eating Time in the treatment of type 2 diabetes) trial is to investigate the effects on glycaemic control (HbA) and the feasibility of a 1-year TRE intervention in individuals with overweight/obesity and type 2 diabetes. The aim of the present paper is to describe the protocol for the RESET2 trial.
View Article and Find Full Text PDFJCEM Case Rep
January 2025
Department of Endocrinology, St. Luke's University Health Network, Bethlehem, PA 18015, USA.
Routine serum studies in a female patient with sustained prediabetic glycated hemoglobin A (HbA) levels, controlled on metformin, yielded an unexpected finding: an elevated HbA value of ≥14.9% (≥139 mmol/mol) (normal reference range, <5.7% to <39 mmol/mol).
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!