Diabetes, Obesity and Metabolism

Cover image for Vol. 17 Issue 6

Edited By: R. Donnelly and A. Garber

Impact Factor: 5.456

ISI Journal Citation Reports © Ranking: 2013: 17/124 (Endocrinology & Metabolism)

Online ISSN: 1463-1326

2015 Virtual Issue on Review Articles

FREE access to a virtual issue containing pertinent reviews from Diabetes, Obesity and Metabolism

Review of Reviews: a virtual issue
Richard IG Holt*


For the last two years Diabetes, Obesity and Metabolism has produced a freely available virtual issue of a selection of reviews that were accepted in the previous year. Given its popularity judging by the number of downloads, we have decided to continue with this for a further year. Again we have accepted a wide breadth of articles discussing different aspects of the therapeutics of diabetes, obesity and metabolism.

Some have had a broad focus, such as treatment of older people with diabetes (1;2) and biosimilar insulin (3), while others have described the actions of individual drugs (4-6). There have been articles considering the safety of drugs (2;7-10) or the use of drugs in special populations (11-13). New drug targets (14-16), lifestyle issues (17) and pharmacological prevention of diabetes (18) have all been included. Alas not all of these articles could be contained within the virtual issue and again I have made a personal choice for inclusion.

For many years, specific insulin analogues have been made by single manufacturers but as they are coming to the end of their patents, biosimilar insulins made by other companies are likely to enter clinical practice in the near future. The implication of this development for clinical practice and regulation are elucidated in the review by deVries and colleagues (3).

Diabetes affects 10–30% of elderly people worldwide and 40% of those with diabetes are elderly, at least in high income countries. Diabetes in older people may present significant challenges to the patient and their healthcare team, particularly in the context of associated co-morbidities and often complex clinical decision-making. This issue is sensitively reviewed by Valencia and colleagues (1). Avoidance of hypoglycaemia is a key goal in the elderly and the role of DPP-4 inhibitors in preventing this burden is described by Avogaro and co-authors (2).

Safety continues to dominate our choices of treatments, particularly in view of the on-going debate about certain diabetes drugs and cardiovascular risk. Both the effects of GLP-1 receptor agonists and sulphonylurea drugs on cardiovascular disease were reviewed last year (8;10).

It was good news to hear last year that diabetes is no longer the commonest cause of blindness in people of working age in the UK. Much of this is a testament to improved glucose and blood pressure control as well as timely screening for retinopathy. Nevertheless it remains an important clinical problem and the new treatments reviewed by Das et al are needed to improve the vision of people with significant retinopathy (12).

Co-morbidity of type 1 diabetes with coeliac disease creates additional challenges for patient and healthcare professional alike. Early initiation of a gluten-free diet is associated with improved complications, growth and bone density and may even prevent additional autoimmune diseases. Leonard and colleagues have described what clinicians need to do to identify and treat those with coeliac disease adequately (11).

Obesity remains a challenge for those with type 2 diabetes. Although some of the newer treatments are associated with less weight gain than previously, lifestyle intervention is essential to help people manage their weight. The large Look AHEAD trial showed that an intensive lifestyle intervention led to reduction in weight and HbA1c and improved fitness and cardiovascular risk factors. However, there was no effect on cardiovascular disease event. The implications of this study are discussed by Wing (17).

Prevention of diabetes remains a major goal and although lifestyle interventions are highly effective, they are not suitable for all and drug treatments are needed for some people. However, the current evidence for pharmacological interventions, reviewed by Bethel et al, remains disappointing when long-term hard diabetes outcomes such as complications and mortality are considered (18).

I hope you find this year’s virtual issue as enjoyable as previous years and that it inspires you to consider writing for Diabetes Obesity and Metabolism. I would also encourage you to look up the other reviews that I was unable to include.

Conflict of Interest: RH is the Reviews Editor of Diabetes Obesity and Metabolism

II. Articles

Biosimilar insulins: a European perspective
DeVries, J H, Gough, S, Kiljanski, J, Heinemann, L.

Pharmacological treatment of diabetes in older people
Valencia, W, Florez, H.

DPP-4 inhibitors can minimize the hypoglycemic burden and enhance safety in elderly people with diabetes
Avogaro, A, Dardano, A, Vigili de Kreutzenberg, S, Del Prato, S.

GLP-1 receptor agonists and cardiovascular risk in type 2 diabetes – a clinical perspective
Fisher, M.

Mortality risk with sulfonylureas compared to metformin
Holden, S, Currie, C.

New treatments of diabetic retinopathy
Das, A, Stroud, S, Mehta, A, Rangasamy, S.

Managing coeliac disease in people with diabetes
Leonard, M, Cureton, P, Fasano, A.

Implications of look AHEAD for clinical trials and clinical practice
Wing, R.

Pharmacological interventions for preventing or delaying onset of type 2 diabetes mellitus
Theodorakis, M, Bethel, A, Xu, W.

III Reference List

(1) Valencia WM, Florez H. Pharmacological treatment of diabetes in older people. Diabetes Obes Metab 2014 Dec;16(12):1192-203.

(2) Avogaro A, Dardano A, de Kreutzenberg SV, Del PS. Dipeptidyl peptidase-4 inhibitors can minimize the hypoglycaemic burden and enhance safety in elderly people with diabetes. Diabetes Obes Metab 2015 Feb;17(2):107-15.

(3) DeVries JH, Gough SC, Kiljanski J, Heinemann L. Biosimilar insulins: a European perspective. Diabetes Obes Metab 2014 Nov 7.

(4) Schmidt LJ, Habacher W, Augustin T, Krahulec E, Semlitsch T. A systematic review and meta-analysis of the efficacy of lixisenatide in the treatment of patients with type 2 diabetes. Diabetes Obes Metab 2014 Sep;16(9):769-79.

(5) Van Laecke S, Van Biesen W, Vanholder R. The paradox of bardoxolone methyl: a call for every witness on the stand? Diabetes Obes Metab 2015 Jan;17(1):9-14.

(6) Bronden A, Hansen M, Sonne DP, Rohde U, Vilsboll T, Knop FK. Sevelamer in a diabetologist's perspective: a phosphate-binding resin with glucose-lowering potential. Diabetes Obes Metab 2015 Feb;17(2):116-20.

(7) Scibora LM. Skeletal effects of bariatric surgery: examining bone loss, potential mechanisms and clinical relevance. Diabetes Obes Metab 2014 Dec;16(12):1204-13.

(8) Holden SE, Currie CJ. Mortality risk with sulphonylureas compared to metformin. Diabetes Obes Metab 2014 Oct;16(10):885-90.

(9) Giorda CB, Nada E, Tartaglino B, Marafetti L, Gnavi R. A systematic review of acute pancreatitis as an adverse event of type 2 diabetes drugs: from hard facts to a balanced position. Diabetes Obes Metab 2014 Nov;16(11):1041-7.

(10) Fisher M. Glucagon-like peptide 1 receptor agonists and cardiovascular risk in type 2 diabetes: a clinical perspective. Diabetes Obes Metab 2014 Aug 23.

(11) Leonard MM, Cureton PA, Fasano A. Managing coeliac disease in patients with diabetes. Diabetes Obes Metab 2015 Jan;17(1):3-8.

(12) Das A, Stroud S, Mehta A, Rangasamy S. New treatments for diabetic retinopathy. Diabetes Obes Metab 2015 Mar;17(3):219-30.

(13) Davis TM. Dipeptidyl peptidase-4 inhibitors: pharmacokinetics, efficacy, tolerability and safety in renal impairment. Diabetes Obes Metab 2014 Oct;16(10):891-9.

(14) Colca JR, McDonald WG, Kletzien RF. Mitochondrial target of thiazolidinediones. Diabetes Obes Metab 2014 Nov;16(11):1048-54.

(15) Altaf QA, Barnett AH, Tahrani AA. Novel therapeutics for type 2 diabetes: insulin resistance. Diabetes Obes Metab 2014 Oct 11.

(16) Sahebkar A, Watts GF. Role of selective peroxisome proliferator-activated receptor modulators in managing cardiometabolic disease: tale of a roller-coaster. Diabetes Obes Metab 2014 Sep 1;16(9):780-92.

(17) Wing RR. Implications of Look AHEAD for clinical trials and clinical practice. Diabetes Obes Metab 2014 Dec;16(12):1183-91.

(18) Bethel MA, Xu W, Theodorakis MJ. Pharmacological interventions for preventing or delaying onset of type 2 diabetes mellitus. Diabetes Obes Metab 2015 Mar;17(3):231-44.

*Richard IG Holt
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, UK
Address for Correspondence: Professor Richard IG Holt, IDS Building (MP887), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
Tel: +44 23 8079 4665 Fax: +44 23 8079 5255
e-mail: R.I.G.Holt@southampton.ac.uk