Interindividual differences in the clinical effectiveness of liraglutide in Type 2 diabetes: a real-world retrospective study conducted in Spain.

AIMS: To study the response of clinical variables (HbA1c , body weight, lipid profile and blood pressure) over 24 months of liraglutide treatment in a real-world clinical setting, and to describe the evolution of HbA1c and body weight reduction in response to liraglutide treatment by employing generalized additive mixed models (GAMMs). METHODS: We included people aged ≥ 18 years with Type 2 diabetes mellitus that initiated liraglutide treatment between November 2011 and May 2015. Demographic and clinical data were retrieved retrospectively over 24 months from electronic medical records with a median duration of observation of 7.0 (IQR 3.0-12.0) months. RESULTS: Individuals that initiated liraglutide therapy were obese (BMI 39.1 kg/m2 ), with inadequate HbA1c (68 mmol/mol [8.4%]), blood pressure and lipid levels. Upon liraglutide treatment, HbA1c , body weight, mean systolic and diastolic blood pressure, and lipid levels decreased gradually. GAMMs demonstrated that longer treatment with liraglutide was a predictor of improved HbA1c response, whereas higher baseline HbA1c , longer Type 2 diabetes duration and treatment with insulin were predictors of worse HbA1c response. Higher baseline weight, longer treatment with liraglutide and the interaction between metformin and time were predictors of improved weight response. CONCLUSIONS: In this real-world study, we showed the effectiveness of liraglutide in improving body weight, HbA1c , mean systolic and diastolic blood pressure, and lipid levels. GAMMs indicated that baseline HbA1c and weight, time of treatment with liraglutide, diabetes duration and the use of metformin or insulin are predictors of clinical response to liraglutide.

Síncope e hipotiroismo. Una relación razonable / Syncope and hypothryroidism. A reasonable relation

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Incidence of Type 1 diabetes in children in Cáceres, Spain, during 1988-1999.

AIM: To determine the incidence of Type 1 diabetes in Cáceres in children less than 14 years of age. We tested for differences in incidence by age, sex and season at diagnosis. METHODS: All Type 1 diabetes cases with onset <14 years of age between 1988 and 1999 were recorded retrospectively. Pediatric Unit registries provided the primary source of ascertainment. The secondary independent data source was based on the registries of local Diabetic Associations, diabetes camp records and guarantee cards of blood-glucose meters. We used the capture-recapture method for ascertainment. RESULTS: During the 12-year period, 137 new cases of Type 1 diabetes were identified. Completeness of ascertainment was 99.2%. Average annual observed incidence was 16.8/100,000/year (95% C.I. 14.1-19.8). Age-standardised incidence (world population): 16.5/100,000/year (95% C.I. 13.9-19.6). Average annual incidence for 0-4, 5-9 and 10-13-year-old groups: 12.7/100,000 (95% C.I. 8.8-17.9), 18.2/100,000 (95% C.I. 13.7-23.8) and 19.1/100,000 (95% C.I. 14.2-25.1). The highest age-specific annual incidence rate was found in the 10-13-year age group. There was a seasonal onset pattern, with the highest incidence in autumn and winter. November was the month with the highest number of cases (22/137). CONCLUSION: Cáceres has a moderately high incidence of Type 1 diabetes in children less than 14 years of age, similar to that found in other more developed and densely populated regions of Spain, and in the range of other countries of northern Europe. These data do not support the hypothesis of a decrease in the incidence of the disease from north to south over Europe.

Incidence of type I diabetes among children and young adults (0-29 years) in the province of Badajoz, Spain during 1992 to 1996.

In this study, we determine the incidence of Type I (insulin-dependent) diabetes mellitus in the 0-29-y-old group in Badajoz (the largest and least developed province of Spain). We test for differences in incidence by age at diagnosis, time cluster and sex. Diabetes clinics and periodic review of hospital administration data provided the primary source of ascertainment. The secondary independent data source was based on registries of local Diabetic Associations and guarantee cards of blood glucose meters. Data were collected retrospectively in the period 1992-95 and prospectively for 1996. During the 5-y period (1992-96), 186 new cases of Type I diabetes were identified. Completeness of ascertainment was 95%. Average annual incidence (95% CI) for the 0-14, 15-29 and 0-29-y-old groups was 17.6/100,000 (14.5-21.2), 8.8/100,000 (6.9-11.1) and 12.8/100,000 (11-14.7). The highest age-specific annual incidence rate was found in the 10-14 age group: 23.4/100,000 (17.6-30.4). The incidence in males (14.7/100,000/y) was higher than in females (10.7/100,000/y). There was a seasonal onset pattern, with the highest incidence in autumn and winter. October was the month with the highest number of new cases (29/186). The province of Badajoz has a moderately high incidence of Type I diabetes in 0-14-y-old children, similar to that found in other more developed and densely populated regions of Spain. These data contradict the hypothesis of a decrease in the incidence of the disease from north to south over Europe.

[Advances in pharmacological treatment of pituitary adenomas]. / Avances en el tratamiento farmacológico de los adenomas hipofisarios.

In last years, advances in endocrinological and neuroradiological research have lead to an earlier recognition and more effective management of pituitary tumours. At the same time, pharmacological investigation has allowed the development of useful drugs in the treatment of pituitary adenomas, either as an exclusive therapy or as an aid to surgery and radiotherapy. In this article we review indications and dosage of recently developed drugs for different types of hormone-secreting pituitary adenomas.