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Article: Awareness of Genetic Polymorphism in Drug Metabolizing Enzymes and Transporters May Promote Personalized Type 2 Diabetes Management [Response to Letter].

Williams, David M / Stephens, Jeffrey W

Diabetes, metabolic syndrome and obesity : targets and therapy

2022 Volume 15, Page(s) 741–742

Language	English
Publishing date	2022-03-07
Publishing country	New Zealand
Document type	Journal Article ; Comment
ZDB-ID	2494854-8
ISSN	1178-7007
ISSN	1178-7007
DOI	10.2147/DMSO.S363555
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Article ; Online: Changes in Cognitive Function Following Bariatric Surgery: An Updated Systematic Review.

Hathaway, Isaac / Momodu, Oshiokhe Esther / Williams, David M / Beamish, Andrew J / Barry, Jonathan / Stephens, Jeffrey W

Obesity surgery

2024

Abstract: Since a previous systematic review published in 2016, there have been further studies investigating the association of changes in cognitive function following bariatric surgery. All studies since the original review that reported at least one element of ... ...

Abstract	Since a previous systematic review published in 2016, there have been further studies investigating the association of changes in cognitive function following bariatric surgery. All studies since the original review that reported at least one element of cognitive function before and after bariatric surgery were eligible. A total of 137 additional studies were identified; 13 were included in addition to the 18 studies previously. Almost all studies reported improvements in at least one domain. Most revealed improvements were limited to a few domains and were not universal. Further findings investigated cognitive function improvement in relation to procedure choice, and mental health or quality of life post-surgery. Further high-powered studies are still necessary, but these findings support the impact of bariatric surgery on cognitive function in obesity.
Language	English
Publishing date	2024-04-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-024-07235-z
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Zs.A 3381: Show issues

Location:
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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Personalized Type 2 Diabetes Management: An Update on Recent Advances and Recommendations.

Williams, David M / Jones, Hannah / Stephens, Jeffrey W

Diabetes, metabolic syndrome and obesity : targets and therapy

2022 Volume 15, Page(s) 281–295

Abstract: Previous guidelines for the treatment of people with type 2 diabetes mellitus (T2D) have relied heavily upon rigid algorithms for the sequential addition of pharmacotherapies to achieve target glycemic control. More recent guidelines advocate a ... ...

Abstract	Previous guidelines for the treatment of people with type 2 diabetes mellitus (T2D) have relied heavily upon rigid algorithms for the sequential addition of pharmacotherapies to achieve target glycemic control. More recent guidelines advocate a personalized approach for diabetes treatment, to improve patient satisfaction, quality of life, medication adherence and overall health outcomes. Clinicians should work with patients to develop personalized goals for their treatment, including targeted glycemic control, weight management, prevention and treatment of associated comorbidities and avoidance of complications such as hypoglycemia. Factors that affect the intensity of treatment and choice of pharmacotherapy should include medical and patient influences. Medical considerations include the diabetes phenotype, biomarkers including genetic tests, and the presence of comorbidities such as cardiovascular, renal, or hepatic disease. Patient factors include their treatment preference, age and life expectancy, diabetes duration, hypoglycemia fear and unawareness, psychological and social circumstances. The use of a personalized approach in the management of people with T2D can reduce the cost and failure associated with the algorithmic "one-size-fits-all" approach, to anticipate disease progression, improve the response to diabetes pharmacotherapy and reduce the incidence of diabetes-associated complications. Ultimately, the use of personalized medicine in people with T2D should improve medication adherence, patient satisfaction and quality of life to reduce diabetes distress and improve physical health outcomes.
Language	English
Publishing date	2022-02-04
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2494854-8
ISSN	1178-7007
ISSN	1178-7007
DOI	10.2147/DMSO.S331654
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Article: Benefits in routinely measured liver function tests following bariatric surgery: a retrospective cohort study.

Roberts, Richard / Williams, David M / Min, Thinzar / Barry, Jonathan / Stephens, Jeffrey W

Journal of diabetes and metabolic disorders

2023 Volume 22, Issue 2, Page(s) 1763–1768

Abstract: Background: Bariatric surgery is well-established to support long-term metabolic health benefits associated with considerable weight loss. Here, we aim to determine the longer-term impact of bariatric surgery on liver enzymes and associations with other ...

Abstract	Background: Bariatric surgery is well-established to support long-term metabolic health benefits associated with considerable weight loss. Here, we aim to determine the longer-term impact of bariatric surgery on liver enzymes and associations with other metabolic improvements. Methods: One hundred patients who underwent bariatric surgery between 2007 and 2014 were included, and changes in liver enzymes, anthropometric measures and other parameters were observed over a mean 9.8 years. Results: At the time of surgery, the mean age was 45.4 ± 9.6 years, weight 141.2 ± 31.6 kg, and body mass index (BMI) 50.2 ± 10.1 kg/m Conclusions: Bariatric surgery is associated with rapid and sustained improvements in routine liver enzymes at 10 years, and sustained improvements in features of the metabolic syndrome. Supplementary information: The online version contains supplementary material available at 10.1007/s40200-023-01311-4.
Language	English
Publishing date	2023-09-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2680289-2
ISSN	2251-6581
ISSN	2251-6581
DOI	10.1007/s40200-023-01311-4
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Article ; Online: Chronic kidney disease in type 2 diabetes: Implications for managing glycaemic control, cardiovascular and renal risk.

Stephens, Jeffrey W / Brown, Karen E / Min, Thinzar

Diabetes, obesity & metabolism

2020 Volume 22 Suppl 1, Page(s) 32–45

Abstract: This review examines the current literature relating to diabetes related kidney disease (DKD) and the optimal management of cardio-renal risk. DKD develops in approximately 40% of patients with type 2 diabetes mellitus. The mainstay of therapy is to ... ...

Abstract	This review examines the current literature relating to diabetes related kidney disease (DKD) and the optimal management of cardio-renal risk. DKD develops in approximately 40% of patients with type 2 diabetes mellitus. The mainstay of therapy is to reduce the progression of DKD by optimising hyperglycaemia, blood pressure, lipids and lifestyle. Evidence supports the role for renin-angiotensin system blockade in limiting the progression of DKD. Recent data from diabetes related cardiovascular outcome trials and renal specific trials have provided a novel insight on the additional benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in reducing the progression of DKD as well as cardiovascular risk. Lessons have been learnt from CREDENCE and there are expectations that DAPA-CKD and EMPA-KIDNEY will further support the benefits of SGLT2 inhibition in relation to DKD. As a consequence, international guidelines have been updated to reflect the positive benefits. In addition, novel steroidal mineralocorticoid receptor antagonists offer a potential role in future years. The review examines the current evidence and future approach to optimising outcomes for renal protection in patients with diabetes.
MeSH term(s)	Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetic Nephropathies/prevention & control ; Glycemic Control ; Humans ; Kidney ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/drug therapy ; Renal Insufficiency, Chronic/prevention & control ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2020-04-07
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1454944-x
ISSN	1463-1326 ; 1462-8902
ISSN (online)	1463-1326
ISSN	1462-8902
DOI	10.1111/dom.13942
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Zs.A 5442: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Nonalcoholic fatty liver disease in diabetes: Overlooked or just ignored?

Williams, David M / Krishnamoorthy, Sk V / Ch'ng, Chin L / Stephens, Jeffrey W / Min, Thinzar

Obesity (Silver Spring, Md.)

2022 Volume 30, Issue 5, Page(s) 969–970

MeSH term(s)	Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Humans ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/epidemiology
Language	English
Publishing date	2022-04-04
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2230457-5
ISSN	1930-739X ; 1071-7323 ; 1930-7381
ISSN (online)	1930-739X
ISSN	1071-7323 ; 1930-7381
DOI	10.1002/oby.23423
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Zs.A 4061: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MG 87: Show issues

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Article ; Online: Achievement of the ESC recommendations for secondary prevention of cardiovascular risk factors in high-risk patients with type 2 diabetes: A real-world national cohort analysis.

Salem, Ahmed M / Harris, Daniel / Bray, Jonathan J H / Obaid, Daniel R / Stephens, Jeffrey W / Halcox, Julian

International journal of cardiology

2023 Volume 377, Page(s) 104–111

Abstract: Aim: To assess compliance with European Society of Cardiology (ESC) secondary prevention recommendations in a nationwide contemporary population with diabetes mellitus (DM) and coronary artery disease.: Method: We conducted a retrospective ... ...

Abstract	Aim: To assess compliance with European Society of Cardiology (ESC) secondary prevention recommendations in a nationwide contemporary population with diabetes mellitus (DM) and coronary artery disease. Method: We conducted a retrospective observational study using linked health data in patients across Wales with DM undergoing percutaneous coronary intervention (2012-2017). The follow-up was for one year. We analysed the clinical characteristics, medications, target levels for HbA1c, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and blood pressure against the ESC prevention guidelines. Results: Overall, 3478 patients with diabetes had available data at 1-year post-PCI. Only 43% had HbA1c levels <53 mmol/L, but 81% had blood pressure < 140/80 (current ESC targets). Prescribing frequency of the newer hypoglycaemic agents (glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter 2 inhibitors) was suboptimal, with a higher rate in patients with HbA1c ≥53 mmol/mol. Only 51% & 27% of the patients had LDL-C levels <1.8 &1.4 mmol/L (2016 & 2019 guidelines recommendations respectively), and 55% & 34% had non-HDL-C levels <2.6 & 2.2 mmol/L (2016 & 2019 guidelines respectively). Of the uncontrolled LDL-C patients, 42% (2016 target) and 35% (2019 target) were prescribed high-intensity statins. Females were more likely to have LDL-C targets above the recommended level. Conclusion: Achievement of ESC treatment goals in this very-high risk cohort for DM and hyperlipidaemia was far from optimal, with a low prescription rate of the guidelines-recommended therapy. Target goals for hypertension were met more frequently. An up-to-date analysis reflecting the current practice against the most recent guidelines is warranted.
MeSH term(s)	Female ; Humans ; Cholesterol, LDL ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/chemically induced ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Percutaneous Coronary Intervention ; Secondary Prevention ; Glycated Hemoglobin ; Risk Factors ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Cholesterol ; Cohort Studies ; Heart Disease Risk Factors ; Cardiology
Chemical Substances	Cholesterol, LDL ; Glycated Hemoglobin ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	2023-02-09
Publishing country	Netherlands
Document type	Observational Study ; Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2023.02.004
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Zs.A 1673: Show issues

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Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Freestyle libre use in people with type 2 diabetes using basal-bolus insulin is associated with improved glycaemic control: A real-world analysis.

Williams, David M / Crockett, Elin / Aye, Su / Latheef, Muhammed R / Chokor, Mahmoud / Roberts, Richard / Bain, Stephen C / Stephens, Jeffrey W / Min, Thinzar

Primary care diabetes

2023 Volume 17, Issue 2, Page(s) 202–203

MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Hypoglycemic Agents/adverse effects ; Diabetes Mellitus, Type 1 ; Insulins ; Blood Glucose Self-Monitoring ; Blood Glucose
Chemical Substances	Hypoglycemic Agents ; Insulins ; Blood Glucose
Language	English
Publishing date	2023-01-13
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2273997-X
ISSN	1878-0210 ; 1751-9918
ISSN (online)	1878-0210
ISSN	1751-9918
DOI	10.1016/j.pcd.2023.01.004
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Article: Diabetes management in older adults who fall: a study amongst older adults presenting to the emergency department.

Burgess, Alexandra J / Williams, David M / Collins, Kyle / Roberts, Richard / Burberry, David J / Stephens, Jeffrey W / Davies, Elizabeth A

European geriatric medicine

2023 Volume 14, Issue 5, Page(s) 1105–1110

Abstract: Introduction: Type 2 diabetes mellitus (T2D) is associated with poor health outcomes whilst tight glycaemic targets are questionable in those aged over 70 years with increased frailty. Our aim was to examine whether people with T2D admitted to hospital ... ...

Abstract	Introduction: Type 2 diabetes mellitus (T2D) is associated with poor health outcomes whilst tight glycaemic targets are questionable in those aged over 70 years with increased frailty. Our aim was to examine whether people with T2D admitted to hospital with a fall, were more likely to have greater frailty, increased mortality and co-morbidity burden, or risk factors for falls than people without T2D, and whether these differences were associated with medications used for the treatment of T2D. Methods: The Older Persons Assessment Service (OPAS) is a local emergency department (ED) service, which accepts patients on frailty criteria. The OPAS accepts patients primarily aged over 70 years who present with frailty and geriatric syndromes such as falls, with retrieval from the ED department directly to the service from triage. The OPAS databank was analysed for people with T2D admitted with a fall between June 2020-September 2022. We examined clinical outcomes relating to medication, age, Charlson co-morbidity index (CCI) and clinical frailty score (CFS). Results: 1081 patients were included: 294 (27.2%) with T2D and a mean HbA1c of 53.9 (± 15.8) mmol/mol [7.1%]. People with T2D had a similar mean CFS and age compared to those without T2D, but higher mean CCI (7.0 ± 2.2 vs 5.9 ± 2.1, p < 0.001). Of those people with T2D, 175 (59.5%) and 240 (81.6%) had a HbA1c ≤ 53 mmol/mol [7.0%] and ≤ 64 mmol/mol [8.0%], respectively. In total, 48 (16.3%) people with T2D were identified to have a capillary blood glucose below 4.0 mmol/L on admission to the ED. At 12 months' follow-up, 831 (76.9%) patients were alive and 250 (23.1%) had died. People with T2D treated with insulin and/or gliclazide had a greater 1-year mortality (36.6% vs 23.6%, p < 0.05), greater frequency of hypoglycaemia (35.4% vs 11.8%, p < 0.001), and greater HbA1c (65.5 ± 17.2 mmol/mol [8.2] vs 48.9 ± 12.1 mmol/mol [6.6%]) compared to those who used other agents. Logistic regression confirmed a diagnosis of T2D was associated with 1-year mortality, but mortality was not significantly associated with hypoglycaemic-inducing agents. People with T2D were not more likely to live in deprived areas. Conclusions: A diagnosis of T2D is associated with greater 1-year mortality, and may be influenced by use of hypoglycaemia-inducing diabetes medications. Clinician awareness can support de-prescribing for patients with frailty and HbA1c < 64 mmol/mol.
Language	English
Publishing date	2023-08-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2556794-9
ISSN	1878-7657 ; 1878-7649
ISSN (online)	1878-7657
ISSN	1878-7649
DOI	10.1007/s41999-023-00848-0
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Article ; Online: The effect of sodium-glucose cotransporter-2 inhibitors on inflammatory biomarkers: A meta-analysis of randomized controlled trials.

Buttice, Leonardo / Ghani, Maryam / Suthakar, Janahan / Gnanalingham, Sathyan / Carande, Elliott / Kennedy, Brett W C / Pitcher, Alex / Gamble, James H P / Ahmad, Mahmood / Lewis, Andrew / Jüni, Peter / Rider, Oliver J / Stephens, Jeffrey W / Bray, Jonathan J H

Diabetes, obesity & metabolism

2024

Abstract: Aims: To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers.: Methods: Medline, Embase and the Cochrane Library were searched for RCTs ... ...

Abstract	Aims: To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers. Methods: Medline, Embase and the Cochrane Library were searched for RCTs investigating the effect of SGLT2 inhibitors on inflammatory biomarkers, adipokine profiles and insulin sensitivity. Results: Thirty-eight RCTs were included (14 967 participants, 63.3% male, mean age 62 ± 8.6 years) with a median (interquartile range) follow-up of 16 (12-24) weeks. Meta-analysis showed that SGLT2 inhibitors significantly improved adiponectin, interleukin-6, tumour necrosis factor receptor-1 (vs. placebo alone: standardized mean difference [SMD] 0.34 [95% confidence interval {CI} 0.23, 0.45], mean difference [MD] -0.85 pg/mL [95% CI -1.32, -0.38], SMD -0.13 [95% CI -0.20, -0.06], respectively), leptin and homeostatic model assessment of insulin resistance index (vs. Control: SMD -0.20 [95% CI -0.33, -0.07], MD -0.83 [95% CI -1.32, -0.33], respectively). There were no significant changes in C-reactive protein (CRP), tumour necrosis factor-α, plasminogen activator inhibitor-1, fibroblast growth factor-21 or monocyte chemoattractant protein-1. Conclusions: Our analysis shows that SGLT2 inhibitors likely improve adipokine biomarkers and insulin sensitivity, but there is little evidence that SGLT2 inhibitors improve other inflammatory biomarkers including CRP.
Language	English
Publishing date	2024-04-11
Publishing country	England
Document type	Journal Article
ZDB-ID	1454944-x
ISSN	1463-1326 ; 1462-8902
ISSN (online)	1463-1326
ISSN	1462-8902
DOI	10.1111/dom.15586
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