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New Delhi, August 07, 2018 :
Reversal of diabetes
A clinical trial recently showed that nearly half of individuals with type 2 diabetes achieved remission to a non-diabetic state after a weight-loss intervention delivered within 6 years of diagnosis. Now a study published August 2nd in the journal Cell Metabolism reveals that this successful response to weight loss is associated with the early and sustained improvement in the functioning of pancreatic beta cells. This finding challenges the previous paradigm that beta-cell function is irreversibly lost in patients with type 2 diabetes.
The responders demonstrated early and sustained improvement in beta-cell function. The most striking difference between responders and non-responders was the first-phase insulin response. Pancreatic beta cells secrete insulin in two phases in response to an increase in blood glucose concentration. The first phase, which consists of a brief spike lasting approximately 10 minutes, is typically absent in patients with type 2 diabetes. First-phase insulin secretion increased in responders after weight loss but did not change in non-responders.
Dabigatran in patients with myocardial injury after non-cardiac surgery
In all patients with perioperative myocardial infarction or myocardial injury after non-cardiac surgery (MINS) not at increased bleeding risk, one should give dabigatran 110 mg twice daily for two years. They are at increased risk for short- and long-term adverse cardiovascular outcomes. Currently we treat all such patients with aspirin and a statin.
In the MANAGE trial, over 1750 MINS patients were randomly assigned to dabigatran 110 mg or placebo twice daily for a maximum of two years. Dabigatran treatment lowered the risk of major vascular complications (vascular mortality and nonfatal myocardial infarction, non-hemorrhagic stroke, peripheral arterial thrombosis, amputation, and symptomatic venous thromboembolism) compared with placebo (11% vs 15%). The risk of major bleeding was similar between the groups (3% vs 4%).
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
HealthySoch
