VOLUME 7 NUMBER 4 • NOVEMBER 2010
167
SA JOURNAL OF DIABETES & VASCULAR DISEASE
EASD WATCH
2010 UPDATE FROM STOCKHOLM
European Association for the Study of Diabetes
Contributors:
Dr W de Lange, University of the Free State, Bloemfontein, Dr G Hough, specialist endocrinologist, East London
SUMMARIES
EASD WATCH
DIABETES MORBIDITY AND
MORTALITY
Diabetes and insulin duration and
cancer incidence: a register linkage
study in Denmark
Diabetes patients carry an increased risk for
the development of cancer. The risk is even
greater (about 50%) when the patient uses
insulin as part of his/her treatment regi-
men.
The effect of diabetes duration and
insulin treatment on cancer risk was high-
est shortly after diagnosis. This indicates
that it might not be diabetes duration or
insulin that increased the risk of cancer, but
that it could be related to causes common
to cancer, diabetes and insulin treatment,
for example, obesity.
For all cancers, the effect of insulin
administration was highest shortly after
diagnosis with a rate ratio (RR) of 2 at diag-
nosis, decreasing to a stable level of 1.5 at
three to four years’ diabetes duration. The
same was seen for duration of diabetes,
with an initial RR of 1.5 at diagnosis and
stabilising at an RR of 1.
Diabetes and pancreatitis: a pop-
ulation-based study to determine
the prevalence and incidence of
pancreatitis in people with and
without diabetes
There was an increased incidence and prev-
alence of pancreatitis in patients suffering
from diabetes mellitus when compared to
the normal population. This may have been
due to the increased numbers of patients
suffering from type 2 diabetes mellitus.
The UK General Practice Research Data-
base was used to study the association
between diabetes mellitus and acute pan-
creatitis; 0.76% of patients suffering from
diabetes mellitus had a previous history of
pancreatitis, whereas 0.17% of the non-
diabetic population had a history of pan-
creatitis.
After correcting for age and gender, the
odds ratio for acute pancreatitis in patients
with diabetes mellitus compared to those
without was 3.05 (95% CI: 2.79–3.35).
The relative risk for pancreatitis in diabetes
patients was 1.47 (95% CI: 1.23–1.76).
THE EFFECTS OF INSULIN BEYOND
GLYCAEMIA
Insulin in patients with acute
myocardial infarction and diabetes
– friend or foe? A report from the
DIGAMI 2 study
It is well known that patients with diabetes
mellitus suffering from myocardial infarc-
tion have a poor prognosis. It also seems
that the drug used to control glucose levels
has a prognostic impact. Insulin is associ-
ated with an increased risk of non-fatal car-
diac events and death due to malignancies,
and metformin seemed to be protective.
The aim of this report, a sub-study of
DIGAMI 2, was to analyse the long-term
morbidity and mortality in relation to dif-
ferent glucose-lowering drugs in patients
with type 2 diabetes mellitus and myocar-
dial infarction.
In DIGAMI 2, patients suffering from
type 2 diabetes mellitus and with a prior
myocardial infarct were randomised to
three groups. Group 1 received insulin-
based treatment, group 2 received in-
hospital insulin followed by conventional
therapy and group 3 received only conven-
TABLE OF CONTENTS
DIABETES MORBIDITY AND MORTALITY
Diabetes and insulin duration and cancer
incidence: a register linkage study in
Denmark ����������������������������������������������������������167
Diabetes and pancreatitis: a population-based
study to determine the prevalence and
incidence of pancreatitis in people with
and without diabetes��������������������������������������167
THE EFFECTS OF INSULIN BEYOND GLYCAEMIA
Insulin in patients with acute myocardial
infarction and diabetes – friend or foe?
A report from the DIGAMI 2 study�����������������167
Body weight increase during the first year of
insulin treatment in patients with type 2
diabetes mellitus; a systematic review and
meta-analysis of different insulin regimens ��168
HbA
1c
FOR DIABETES MELLITUS DIAGNOSIS: NEED
FOR REASSESSMENT?
A comparison of performance using two HbA
1c
cut-off points (a ‘rule-in, rule-out’ spectrum)
and one HbA
1c
cut-off point to detect type 2
diabetes in a multi-ethnic cohort �������������������168
Comparison of HbA
1c
and OGTT in the diagnosis
of diabetes in a high-risk population: the
HUNT-DE-PLAN study, Norway �����������������������168
Diagnosis of abnormal glucose levels in patients
at high risk for the development of diabetes:
a comparison of the OGTT and measurement
of HbA
1c
following the American Diabetes
Association recommendations 2010���������������168
Haemoglobin A
1c
in a population with pre-
diabetes, diagnosed, and previously
undiagnosed diabetes�������������������������������������168
TREATMENT OF DIABETES
Benefits of sensor-augmented pump therapy
outweigh multiple daily injections (STAR 3) in
type 1 diabetes ������������������������������������������������168
ADDICTION study provides impetus to GP-based
diabetes screening and management������������169
Incretin-based therapies �������������������������������������169
Late breaking news on the two clinical trials:
NAVIGATOR and LEAD studies �����������������������169
DIABETIC NEPHROPATHY: CLINICAL TRIALS
Intensive glucose control is renoprotective in type
2 diabetes: new analyses from ADVANCE �����170
Aldosterone reduction during 24 weeks of
treatment with aliskiren or placebo added to
losartan in patients with type 2 diabetes and
nephropathy; an AVOID sub-study ����������������170
DIABETES AND BONE DISEASE ���������������������������170
DIABETES AND PREGNANCY
Screening and prevention of gestational
diabetes������������������������������������������������������������170
Hyperglycaemia and Adverse Pregnancy Outcome
(HAPO) study: frequency of gestational
diabetes mellitus (GDM) at collaborating
centres based on IADPSG consensus
recommended criteria�������������������������������������172
Analysis of pregnancies after new IADPSG
recommendation ���������������������������������������������172
New criteria for diagnosis of gestational diabetes
mellitus in comparison to former diagnostic
criteria concerning maternal postpartum
glucose levels and neonatal complications����172
