Session de Diabétologie | Louvain Médical

Evolution of glycemic control and quality of life of diabetic patients after using Flash glucose self-monitoring: a prospective study involving 248 patients

Stéphanie Rouhard, Vanessa Preumont Published in the journal : March 2019 Category : Session de Diabétologie

In a population of Type 1 diabetic patients, we have evaluated the medium-term impact following the introduction of the FreeStyle Libre (FSL) glucose self-monitoring system on glycemic control, number of hypoglycemia episodes, and patient satisfaction with respect to the device.

A total of 248 patients were included and followed-up for 6 months following the introduction of FSL. The HbA1c levels were 8.1 ± 1.3% at inclusion.

HbA1c was found significantly improved at 6 months, especially in patients with poor glycemic control at inclusion. The number of daily controls was shown to have significantly increased. We have noticed a correlation between the number of scans and time spent within the target levels. The number of hypoglycemia episodes, however, was increased at both 3 and 6 months, despite a reduction in insulin doses. The satisfaction score with respect to the system significantly increased as well, especially in the event of improved glycemic control. The behavior score with respect to the occurrence of hypoglycemia episodes improved as well, with no change in the hypoglycemia fear score.

The FSL use induced an improvement in the glycemic balance of the included Type 1 diabetic patients, especially in case of prior poor glycemic control, which was associated with an improved glycemic control compliance. Satisfaction scores for the system were shown to have improved as well, with patients changing less their daily-life behavior, in an effort to avoid hypoglycemia episodes.

How to treat insulinomas without surgery? The revolution brought about by pancreatic EUS-guided radiofrequency ablation

Pierre H. Deprez, Ivan Borbath Published in the journal : March 2019 Category : Session de Diabétologie

Radiofrequency (RF) is a technique aimed at localized tissue destruction by means of thermal effects. Digestive endoscopy offers multiple potential applications for RF ablation, with some of which currently well-validated. One of its best indications is possibly the ablation of pancreatic insulinomas, given that this technique has revolutionized their management. This easy and simple procedure, associated with a low rate of complications, renders it possible to avoid pancreatic surgery, which is associated with a certain degree of morbidity. However, the technique’s limitations and long-term efficiency still require further validation in prospective trials.

Management of Type 2 diabetes in 2019: the same cost/efficiency ratio? The nephrologist’s perspective

Jean-François Cambier Published in the journal : March 2019 Category : Session de Diabétologie

Diabetic nephropathy is currently the leading cause of chronic end-stage renal disease. Its prevention is essential and implies a multidisciplinary management of the diabetic patient, as based on a strict control of blood glucose levels from the onset of diabetes, control of blood pressure, with a privileged place for either ACE inhibitors or sartans whose anti-proteinuric effect has been well demonstrated, and control of other cardiovascular risk factors. In addition, chronic kidney disease significantly increases the cardiovascular risk of diabetic patients. Recent randomized clinical trials involving the new classes of anti-diabetic agents (DPP4-inhibitors, GLP-1 receptor agonists, and SGLT2-inhibitors) have demonstrated the cardiovascular protection ensured by several molecules (empaglifozin, canaglifozin, dapaglifozin, liraglutide, semaglutide, albiglutide, and dulaglutide), along with an additional nephroprotective effect shown for gliflozins, liraglutide, and semaglutide.

Type 2 diabetes management in 2019: the same cost-efficiency? The cardiologist’s perspectives

Christophe Beauloye Published in the journal : March 2019 Category : Session de Diabétologie

Diabetes is a major cardiovascular risk factor, as it significantly increases the risk of cardiovascular events, such as myocardial infarction or stroke. In addition, once these last complications have occurred, the patient prognosis is poorer. Recently, as well documented in the scientific literature, diabetes has been demonstrated to be a significant risk factor for heart failure. New anti-hyperglycemic treatments for Type 2 diabetes and, particularly, sodium-glucose-2 co-transporter inhibitors have reduced cardiovascular events both in primary and secondary prevention. This pharmacological class has been proven to protect Type II diabetes patients from heart failure and to reduce their mortality. These medications’ impact on the occurrence of acute coronary syndromes appears to be more marginal.

Type 2 diabetes management in 2019: the same cost-efficiency ratio? The diabetologist’s perspective

Michel P. Hermans Published in the journal : March 2019 Category : Session de Diabétologie

The results of 14 prospective randomized clinical trials designed to verify the macrovascular safety of various classes of anti-hyperglycemic agents in T2DM, such as DPP4-inhibitors, SGLT2-inhibitors, and GLP-1 receptor agonists, have confirmed their safety for use in all studies; for some molecules, such as empagliflozine, canagliflozine, dapagliflozine, liraglutide, semaglutide, albiglutide and dulaglutide, the data revealed a beneficial pleiotropic effect on the primary endpoint, usually consisting of a composite of CV death, non-fatal infarction, and non-fatal stroke.

Diabetic Charcot foot: crossed looks on the scientific literature and our 5-year clinical expertise at the University clinics of Saint-Luc

Laura Orioli (1), Dan Putineanu (2), Frank Hammer (3), Bruno Vande Berg (3), Dominique Maiter (1), Bernard Vandeleene (1) Published in the journal : March 2019 Category : Session de Diabétologie

The Charcot foot, a rare medical condition, defines a particular form of the diabetic foot, representing both a diagnostic and therapeutic challenge.

In 2017, we reviewed the medical records of patients with a Charcot foot, who were hospitalized in our diabetic foot unit between 2010 and 2014. In this article, we have combined some of our results with those retrieved from the literature in order to deliver several key messages dedicated to the everyday practice.