The annual European Association for the Study of Diabetes (EASD) conference brings together researchers from all over the world. But this year, due to the coronavirus pandemic, the conference went virtual.
Here, we focus on new research into improving the quality of care on offer for people living with diabetes, to help them manage their condition well.
Getting to the heart of diabetes care
People with type 2 diabetes are at much higher risk of developing cardiovascular problems, like heart failure. New results from Professor Javed Butler from the University of Mississippi Medical Center suggest that an SGLT2 inhibitor called empagliflozin can reduce risk of hospitalisation from heart failure by 28%, both in people with and without type 2 diabetes.
SGLT2 inhibitors, also called gliflozins, are sometimes used to treat type 2 diabetes. They reduce blood sugar levels by increasing the amount of sugar that leaves the body in urine. It’s been known for some time that SGLT2 inhibitors can reduce risk of heart failure in people with or without diabetes. But we still need to understand more about how effective they are in people with existing cardiovascular problems.
The researchers studied over 3,700 people with and without diabetes who had reduced ejection fraction, meaning their hearts push less blood out with every pump, a sign of cardiovascular disease. Half of people received empagliflozin and the other half a placebo for 16 months. The researchers found that those who took empagliflozin experienced fewer hospitalisations for heart problems and that those with type 2 diabetes also had better kidney function and improved blood sugar control.
Cardiovascular disease is a common complication in type 2 diabetes, so it’s crucial we understand how to reduce these risks. Knowing that empagliflozin can reduce the risk of heart failure will help doctors when they are weighing up the risks and benefits of different treatment options for people with type 2 diabetes.
Keeping young people with type 1 in the loop
Closed loop technology, sometimes known as an artificial pancreas system, is often talked of as the future of type 1 diabetes management. But we’re not there yet. One of the big unanswered questions is the effectiveness of the system in young people with type 1 diabetes, as the amount of insulin they need can change quite a lot day-to-day. Professor Eric Renard’s new research looked to see if using a closed loop system for 24 hours a day or just over night was the best approach in young people with type 1 diabetes.
Professor Renard took 122 children with type 1 diabetes aged between 7 and 10 and either put them on a closed loop system for 24 hours a day or only during the evening and night for 18 weeks. Children on the closed loop system 24/7 spent nearly 15% more time in a healthy blood sugar range, compared to 10% more for those who used is only during the evening and night. The researchers saw zero safety issues in either group.
Research showing that 24/7 use of closed loop systems is safe and effective in young people with type 1 diabetes will help this technology become more widely available in the future. Helping young people to maintain healthy blood sugar levels early in their life is a key part of preventing complications developing in later life.
Life expectancy with diabetes
Research by Dr Adrian Heald of the University of Manchester suggests the average person with type 1 diabetes has a life expectancy eight years lower, and those with type 2 diabetes two years lower, compared to people without the condition.
The researchers looked at data from England collected between 2015 and 2016 of 217,000 people on the type 1 diabetes register and 2.5 million people on the type 2 diabetes register, and used statistical models to predict their life expectancy.
Their modelling showed that the average person with type 1 diabetes aged 43 years would be expected to live for 33 more years, compared to 40 years in someone of a similar age without diabetes. It also showed that a person with type 2 diabetes aged 65 would be expected to live for 18 more years, compared to the 20 years for someone without the condition.
While numbers like this can be alarming, we know that keeping blood sugar levels within a healthy range reduces the risk of complications. But this research still highlights the seriousness of diabetes, and the significant impact the condition - and its complications - has on the lives of those living with it. It’s concerning to see that those living with diabetes - particularly those with type 1 - are still at risk of a shorter life expectancy. Data like this is a reminder of how important our research is on new treatments and strategies that will help people with diabetes live longer and healthier lives.
Research into diabetes care is moving forward at a rapid pace. Understanding more about which medications are best for each person, and how new technology like closed loop systems can benefit young people is important for ensuring that everyone gets access to the best quality of care they can. There’s still plenty of work to be done, but research like this helps to bring us closer to a world where diabetes does no harm.