Metformin could help keep weight loss patients long-term

1. Metformin may help keep weight loss patients long-term

Summary: http://annals.org/aim/article/doi/10.7326/M18-1605

Editing: http://annals.org/aim/article/doi/10.7326/M19-0782

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In the Diabetes Prevention Program (DPP) clinical trial and long-term follow-up study, among those who lost at least 5 per cent of their body weight during the first year, they were more likely to have sustained long-term weight loss if it was assigned to treatment with metamatone than with plasebo or with lifestyle intervention. Older older people losing more weight in the first year were the most consistent assumptions about losing permanent weight. The results of a cohort study are published in the Annals of Internal Medicine.

Weight loss plays a key role in efforts to prevent or delay type 2 diabetes. So, better weight management could be the result of good long-term weight loss identifiers. The DPP was a randomized controlled trial that compared weight loss and diabetes prevention against metformin, intensive lifestyle intervention (ILS), or placebo among more than 3,000 participants with prediabetes, and its Fruit Study ( DPPOS) noted that patients after the end of the masked treatment. The DPP / DPPOS is the largest and longest-running study of formformin to prevent diabetes.

After the first year, twice the participants in the ILS group compared to the metformin group lost at least 5 percent of their body weight. However, the people who assigned to the metformin group had a better success in retaining their weight loss between years 6 and 15, and the patients were still being followed. The researchers noted that weight loss at one year was predicted to lose long-term weight across all groups. Early weight loss was also important for diabetes incidence. The researchers found that cumulative incidence rates of diabetes were over 15 years lower among those who lost at least 5 per cent of their weight in their first year.

According to the authors of studies, future research should focus on whether metformin intervention could be a useful intervention for weight maintenance after initial weight loss with lifestyle interventions, drugs or anti-forgery devices, or bariatric surgery.

Contacting the media: For an embargo PDF, contact Lauren Evans at laevans@acponline.org. To speak to the main author, Kishore M. Gadde, MD, please contact her by email at Kishore.gadde@pbrc.edu, or Lisa Stanbury at Lisa.Stansbury@pbrc.edu.

2. Poor glycemic control raises risk for premature birth

Abstract: http://annals.org/aim/article/doi/10.7326/M18-1974

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The risk of premature birth to HBA1c was strongly linked to the time of production. Women with HBA1c levels appeared to be at risk with recommended target levels for preterm delivery as well as other adverse pregnancy outcomes. The results of a cohort study are published in the Annals of Internal Medicine.

Type 1 diabetes is known to contribute to pregnancy, but the relationship between maternal glycemic control and premature birth is less clear. At least three major organizations now propose that the HBA1c level will be less than 6.5 per cent during early pregnancy. However, since these recommendations come mainly from research into congenital malformations and infants related to the age of transport, it is not clear whether this severe glycemic control reduces the risk to women of being severe. have type 1 diabetes.

Researchers at Karolinska Institutet in Stockholm, Sweden use Swedish national programs to examine harmful pregnancy results in more than 2,400 single deliveries according to HBA1c levels in mothers with type 1 diabetes. Researchers also examined neonatal death, particularly the age of leave, macrosomia, infant birth injury, hypoglycemia, respiratory distress, low Apgar's score, and stillbirth. They found that an increase in HBA1c levels was associated with increased risks of premature birth, as well as other adverse pregnancy outcomes. Most of the increased risk for preliminary report birth was attributable to pre-reported pre-report births, although spontaneous default births increased with higher HbA1C levels.

According to the researchers, these results are important to develop future guidelines and clinicians to be informed of the risks of poor glycemic control. However, the results do not support the idea that a further reduction in the recommended HBA1c level during early pregnancy will eliminate the risk of premature birth.

Contacting the media: For an embargo PDF, contact Lauren Evans at laevans@acponline.org. To speak to the lead author, Jonas F. Ludvigsson, MD, PhD, please contact the Karolinska Institute Press Office at pressinfo@ki.se or +46 8 524 860 77.

3. National Health Institutions Identifies Ways to Prevent Gaps in Evidence on the Effectiveness and Safety of Long Term Osteoporosis Drug Therapies t

Summary of review and position paper

Review: http://annals.org/am/article/doi/10.7326/M19-0533

Location Paper: http://annals.org/aim/article/doi/10.7326/M19-0961

Editing: http://annals.org/aim/article/doi/10.7326/M19-1112

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Approximately 10 million adults aged 50 or over have osteoporosis and this number is expected to increase as the population ages. Some drug osteoporosis treatments reduce fractures in the short term (up to 3 years), but the best long-term use is definitely. A systematic review of the benefits and harms associated with the treatment of long-term Osteoporosis and retired treatment, or on drug holidays, and an accompanying position paper is published in the Annals of Internal Medicine.

Researchers funded by the National Institutes of Health for Disease Prevention and the Healthcare Research and Quality Agency based in the Clinical Education and Clinical Research Center in the Minneapolis VA Healthcare System and at the University of Minnesota's Evidence-Based Practice Center were reviewed. trials and 13 observational studies. They found that vertebrate and non-invertebrate fractures in women with osteoporosis were reduced over 4 years, compared to placebo for the most part, and zoledronic acid reduced these outbreaks in women with osteopenia. or osteoporosis for 6 years. Control, observation studies indicated that long-term bisphosphonate treatment could increase the risk of serious adverse events but are still rare, such as atypical banoral (AFF) and osteonecrosis penetration (ONJ). The risk to the AFF appears to be greater for longer use. For women with osteoporosis, raloxifene has been reduced for 4 years compared to vertebrate fractures, but not non-feminine fractures, and increased risk of deep toothed thrombosis and pulmonary embolism. For women with unknown osteoporosis or osteopenia status, oral hormone therapy for 5 to 7 years decreased clinical breakdowns and hip fractures compared to placebo, but this was offset by increased risk of cardiovascular disease and cognitive impairment, t and increased risk of estrogen-progestin for invasive breast cancer. The data were insufficient to draw conclusions on the benefits and harm of the long-term use of other FDA-approved drugs, including risedronate, ibandronate, denosumab, teriparatide, and abaloparatide.

The same details were not as clear about clinicians informing of the balance of broken benefits for injuring bisphosphonate drug holidays. This was because alendronate was not followed over 5 years or zoledronic acid over 3 years compared to cessation due to hip or other non-invertebrate outbreaks and vertebrate fractures were not disproportionately reduced. In addition, the observation data suggested that the continuity of Bisphosphonate risk would follow AFF compared to retirement.

According to a Workshop Pathways Report to Prevent the National Institutes of Health focused on research gaps for long-term drug therapies for the prevention of osteoporosis breakdowns, there was insufficient evidence to determine whether drug holidays could be applied in some patients helping to reduce serious risk of adverse events. The Workshop committee recommends further research in this area. They also recommend research in newer treatments, and in the clinical and patient barriers that prevent screening and adherence to osteoporosis drug treatment arrangements.

Contacting the media: For an embargo PDF, contact Lauren Evans at laevans@acponline.org. To interview the main author, Howard Fink, MD, MPH, contact Ralph Heussner at ralph.heussner@va.gov.

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