Oliver Kuss1,2,3 · Michael Roden3,4,5 · Sabrina Schlesinger1,3 · Annika Hoyer6
Received: 27 May 2024 / Accepted: 23 November 2024 / Published online: 12 December 2024 © The Author(s) 2024
Abstract
Aims Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials. We recently applied this approach to the treatment of type 2 diabetes for the clinical outcomes of glycaemic control and body weight and repeat it for the clinical outcome of all-cause mortality.
Methods We performed a meta-regression analysis using digitalized individual participant information on time to death from 10 large cardiovascular outcome trials (7563 deaths from 99,746 participants) on DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors with respect to the variability of all-cause mortality and its potential predictors after treatment.
Results The adjusted difference in log(SD) values of time to death between the verum and placebo arms was −0.036 (95%- CI: −0.059; −0.013), showing larger variability of time to death in the placebo arms. No clinical predictors were found to explain treatment heterogeneity.
Conclusions This analysis suggests that the potential of the precision treatment approach in type 2 diabetes is low, at least with regard to improvement of all-cause mortality in population with high cardiovascular risk. This extends our previous findings for the clinical outcomes of glycaemic control and body weight.
Keywords Dipeptidyl peptidase-4 inhibitors · Glucagon-like peptide 1 · HbA1c · Meta-regression · Precision medicine · Sodium–glucose transporter 2 inhibitors · Type 2 diabetes mellitus
Annunziata Lapolla1 · Maria Grazia Dalfrà1 · Giuseppe Marelli2 · Mario Parrillo3 · Laura Sciacca4 · Maria Angela Sculli5 · Elena Succurro6 · Elisabetta Torlone7 · Ester Vitacolonna8
Received: 18 September 2024 / Accepted: 27 December 2024 / Published online: 22 January 2025 © Springer-Verlag Italia S.r.l., part of Springer Nature 2025
Proper nutrition is essential during pregnancy to ensure an adequate supply of nutrients to the foetus and adequate maternal weight gain. In pregnancy complicated by diabetes (both gestational and pre-gestational), diet in terms of both the intake and quality of carbohydrates is an essential factor in glycaemic control. Maternal BMI at conception defines the correct weight increase during gestation in order to reduce maternal-foetal complications related to hypo- or hyper-nutrition. The recommendations presented here, which are based on national and international guidelines and the most recently published data on nutrition in physiological pregnancy and pregnancy complicated by hyperglycaemia and/or obesity, are designed to help healthcare professionals prescribe suitable eating patterns to safeguard the health of the mother and the foetus.
原创：卢魁
慢性伤口治疗中普遍是什么问题困扰着患者呢？
我们经常能看到些步履蹒跚的老年人和些行动不便的中年人， 他们与那些行色匆匆的年轻人形成了鲜明的对比，这些老年人中有一半以上都会受着各种各样的疾病困扰，而最常见的一种就“慢性伤口”。
原创:卢魁
少吃多尝：宴席上丰盛的四高膳食对糖尿病病情控制十分不利，不少糖尿病病人觉得赴宴后血糖会有所升高，所以糖尿病惠者饮食必须控制总热量，一般以低热量、低脂肪、低糖、高纤维膳食为主。面对宴席上的“四高”食品多尝，以免一吃就超量，要像靖蜓点水一样多样化地品尝一点，选择性地少吃一些。这样既饱了口福，也不至于超量。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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