5 New Things About Diabetes and Risk

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Women with diabetes have twice the cardiovascular disease risk of men, male infertility increases diabetes risk, diabetes elevates hyperkalemia prevalence in patients with chronic kidney disease-these are some of the recent developments in diabetes research that address disease risk and how to manage it.

Catch up here on some of the latest headlines in diabetes care.

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Cardiovascular Risk Doubles in Women With Diabetes

• Women with type 2 diabetes are twice as likely as men to have coronary heart disease, according to a new American Heart Association scientific statement.

• These women have heart attacks at earlier ages; are more likely to die after a first heart attack; and are less likely to undergo procedures to open clogged arteries, receive cholesterol lowering drugs, and have their blood sugar or blood pressure under control.

• Type 2 diabetes develops in women based on sex-specific differences, such as gestational diabetes and polycystic ovary syndrome.

• African-American and Hispanic women with type 2 diabetes are disproportionately affected by coronary artery disease and stroke compared with men.

• Women may need to perform more frequent and intense physical activity to lower their risk of heart attack or stroke.

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Male Infertility Ups Diabetes, Heart Disease Risk

• The risk of diabetes, ischemic heart disease, alcohol abuse, and drug abuse was significantly higher in men who received a diagnosis of male factor infertility than in men who received only infertility testing.

• Similar patterns were identified when those with male factor infertility were compared with vasectomized men.

• The association between male factor infertility and later health outcomes was strongest for men who had longer follow-up.

• The findings suggested that additional investigation is warranted to understand the association and identify interventions to improve outcomes.

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Hyperkalemia and Diabetes Linked With Chronic Kidney Disease

• Diabetes was found to significantly elevate the prevalence of hyperkalemia in patients with chronic kidney disease (CKD).

• The prevalence of hyperkalemia was higher only in patients who had stage 3 CKD.

• In multivariate analysis, stage 4 CKD, use of angiotensin-converting enzyme inhibitors, and smoking were independently associated with hyperkalemia.

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Once-Weekly GLP-1RAs Demonstrate Pros and Cons

• Compared with placebo, all once-weekly glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduced HbA1c and fasting plasma glucose.

• Compared with other once-weekly GLP-1RAs, dulaglutide 1.5 mg; once-weekly exenatide; and taspoglutide, 20 mg, showed a greater reduction of HbA1c, fasting plasma glucose, and body weight.

• Risk of hypoglycemia among once-weekly GLP-1RAs was similar.

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GLP-1R G-protein Biased Agonist Shows Promise

• P5, a potent and selective GLP-1R G-protein-biased agonist, promotes G-protein signaling comparable to GLP-1 and exendin-4 but exhibited a significantly reduced β-arrestin response.

• Treatment of diabetic mice with P5 increased adipogenesis, reduced adipose tissue inflammation and hepatic steatosis, and better corrected hyperglycemia and lowered HbA1c  than exendin-4.

• GLP-1R G-protein-biased agonists may provide a novel therapeutic approach to type 2 diabetes.