Exploring How the Kidney BEAM Physical Activity Digital Health Intervention Improved Mental Health-Related Quality of Life for People Living With Kidney Disease.

Introduction: The Kidney BEAM randomized controlled trial reported clinically meaningful and statistically significant improvements in mental health-related quality of life (HRQoL), physical function (sit-to-stand-60, but not the physical component of HRQoL) and patient activation after a 12-week physical activity digital health intervention (DHI). This study explores factors that contributed to the effectiveness of Kidney BEAM through mixed methods analyses.

Methods: Quantitative data analysis was obtained from the recently published primary manuscript.

Enhanced glucose processing in gestational diabetes diagnosis: Effects on health equity and clinical outcomes.

Objectives: Gestational diabetes is diagnosed using an oral glucose tolerance test (OGTT), which has limited accuracy, reproducibility and practicality. We assessed the effect of enhanced pre-analytical glucose processing upon glucose concentrations, gestational diabetes diagnosis, health equity and pregnancy outcomes, and if HbA1c was a suitable alternative.

Methods: We recruited pregnant women with ≥1 risk factor to a prospective observational cohort study of pregnancy hyperglycaemia, endocrine causes, lipids, insulin and autoimmunity (OPHELIA), from nine UK centres.

Trends in Intermittent Scanning Continuous Glucose Monitoring Usage in The Netherlands-An Opportunity for Elderly Individuals with Diabetes.

Intermittent scanning continuous glucose monitoring (is-CGM) technology has gained widespread adoption and is known to improve glycemic control and quality of life for persons with diabetes. The elderly may lag behind in their adoption of the technology, which could be a potential avenue for improving quality of care. In this study, we investigated the adoption of is-CGM technology in the Dutch population, including effects of age.

Tirzepatide for overweight and obesity management.

Introduction: Tirzepatide is a once-weekly dual agonist, acting on glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors. It is approved at the same doses (5, 10 and 15 mg) for both type 2 diabetes (T2D) and chronic weight management.

Areas Covered: Following a search in PubMed, clinicaltrials.

Surgical and transcatheter aortic valve interventions for aortic stenosis in England: sociodemographic variations in treatment trends and outcome over 20 years.

Background: Health inequalities in cardiovascular care have been identified in the UK. The sociodemographic characteristics of patients undergoing intervention for aortic stenosis (AS) in England, and the impact of COVID-19, is unknown.

Methods: National linked data sets identified all surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) for AS, and post-intervention cardiovascular mortality, between 2000 and 2023.

Designing a regional clinical service for people with early-onset type 2 diabetes in England.

Aims: To design a regional clinical service for people with early-onset type 2 diabetes (EOT2D) in Leicester, Leicestershire and Rutland (England).

Methods: A literature search was undertaken to identify important considerations. A working group of key stakeholders was formed to design a triage system and service pathway.

Incidence of diabetes mellitus following hospitalisation for COVID-19 in the United Kingdom: A prospective observational study.

Background: People hospitalised for coronavirus disease 2019 (COVID-19) have elevated incidence of diabetes. However, it is unclear whether this is due to shared risk factors, confounding or stress hyperglycaemia in response to acute illness.

Methods: We analysed a multicentre prospective cohort study (PHOSP-COVID) of people ≥18 years discharged from NHS hospitals across the United Kingdom following COVID-19.

Physical activity and sedentary behaviour interventions for people living with both frailty and multiple long-term conditions and their informal carers: a scoping review and stakeholder consultation.

Introduction: This scoping review mapped evidence on physical activity (including structured exercise) and sedentary behaviour interventions (interventions to reduce sedentary behaviour) in people living with both frailty and multiple long-term conditions (MLTCs) and their informal carers.

Methods: Ten databases and grey literature were searched from 2000 to October 2023. Two reviewers screened studies and one extracted data.

Kidney Beam-A Cost-Effective Digital Intervention to Improve Mental Health.

Introduction: There is inequity in the provision of physical rehabilitation services for people living with chronic kidney disease (CKD). The Kidney BEAM trial evaluated the clinical value and cost effectiveness of a physical activity digital health intervention (DHI) in CKD.

Methods: In a single-blind, 11 center, randomized controlled trial, 340 adult participants with CKD were randomly assigned to either the Kidney BEAM physical activity DHI or a waitlist control.

The effects of a digital health intervention on patient activation in chronic kidney disease.

My Kidneys & Me (MK&M), a digital health intervention delivering specialist health and lifestyle education for people with CKD, was developed and its effects tested (SMILE-K trial, ISRCTN18314195, 18/12/2020). 420 adult patients with CKD stages 3-4 were recruited and randomised 2:1 to intervention (MK&M) (n = 280) or control (n = 140) groups. Outcomes, including Patient Activation Measure (PAM-13), were collected at baseline and 20 weeks.

Interventions in women with type 2 diabetes mellitus in the pre-pregnancy, pregnancy and postpartum periods to optimise care and health outcomes: A systematic review.

Aims: Type 2 diabetes is a chronic condition affecting increasing numbers of women of reproductive age. Recent UK data show more severe adverse offspring outcomes (stillbirth, neonatal death) than in infants of those with Type 1 diabetes. This systematic review aimed to evaluate randomised controlled trials (RCTs) undertaken in the pre-pregnancy, pregnancy and the postpartum periods in women with Type 2 diabetes, to optimise care and health outcomes.

The effect of high-fibre diets on glycaemic control in women with diabetes in pregnancy: A systematic review and meta-analysis.

Unlabelled: Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy.

Methods: We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes.

Hypertension and diabetes control: faith-based centres offer a promise for expanding screening services and linkage to care in Ghana.

Background: Hypertension and type 2 diabetes mellitus (T2DM) are important contributors to noncommunicable disease related morbidity and mortality. Health systems could benefit from exploring the use of Faith-Based Centres (FBC) to screen and link suspected cases for further care in order to help achieve Sustainable Development Goal (SDG) 3. The study investigated the role of faith-based screening for T2DM and hypertension and the linkage of cases to the healthcare system and examined the care cascade in the Kassena Nankana Districts of Northern Ghana.

How to make cardiology clinical trials more inclusive.

Cardiovascular clinical trials continue to under-represent children, older adults, females and people from ethnic minority groups relative to population disease distribution. Here we describe strategies to foster trial representativeness, with proposed actions at the levels of trial funding, design, conduct and dissemination. In particular, trial representativeness may be increased through broad recruitment strategies and site selection criteria that reflect the diversity of patients in the catchment area, as well as limiting unjustified exclusion criteria and using pragmatic designs that minimize research burden on patients (including embedded and decentralized trials).

Associations between Aircraft Noise, Sleep, and Sleep-Wake Cycle: Actimetric Data from the UK Biobank Cohort near Four Major Airports.

Background: Nighttime aircraft noise may affect people's sleep, yet large-scale evidence using objective and subjective measures remains limited.

Objective: Our aim was to investigate associations between nighttime aircraft noise exposure and objectively measured sleep disturbance using a large UK cohort.

Methods: We used data from 105,770 UK Biobank cohort participants exposed and unexposed to aircraft noise who lived in 44 local authority districts near 4 international airports in England.

Post-COVID changes and disparities in cardiovascular mortality rates in the United States.

Introduction: The COVID-19 pandemic disrupted healthcare delivery and increased cardiovascular morbidity and mortality. This study assesses whether cardiovascular mortality rates in the US have recovered post-pandemic and examines the equity of this recovery across different populations.

Methods: We analyzed data from the CDC WONDER database, covering US residents' mortality from 2018-2023.

A national survey of current rehabilitation service provisions for people living with chronic kidney disease in the UK: implications for policy and practice.

Background: National guidance recognises the key role of rehabilitation in improving outcomes for people living with chronic kidney disease. Implementation of this guidance is reliant upon an adequate and skilled rehabilitation workforce. Data relating to this is currently lacking within the UK.

Age at onset of type 2 diabetes and prevalence of vascular disease and heart failure: Systematic review and dose-response meta-analysis.

Aim: To investigate the relationship between age at diagnosis of type 2 diabetes and the risk of macrovascular disease, heart failure, and microvascular disease.

Methods: In August 2022, PubMed/EMBASE were searched for articles reporting (i) coronary artery disease, cerebrovascular disease, peripheral vascular disease, amputation; (ii) heart failure; and (iii) retinopathy, neuropathy, nephropathy (albuminuria, chronic kidney disease [CKD], end-stage renal disease) by age at diagnosis of type 2 diabetes. Random effects, non-linear dose-response meta-analysis was undertaken for each outcome to assess the association with age at diagnosis (40 years = reference), using both crude and maximally adjusted odds ratios separately, with and without adjustment for current age (age at sampling).