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Diabetes Experts Release New Guidelines on Managing Hyperglycemia in Type 2 Diabetes

John Buse, MD, PhD

New recommendations, co-written by UNC School of Medicine's John Buse, MD, PhD, cover the type of drugs patients should be prescribed and how providers can better help patients manage their health.

BERLIN – The European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) have produced an updated consensus statement on how to manage hyperglycaemia (high blood sugar) in patients with type 2 diabetes. The consensus paper is being published in the EASD's journal, Diabetologia, and the ADA's journal, Diabetes Care. This publication coincides with the EASD annual meeting in Berlin, Germany.

The new recommendations from an expert panel of EASD and ADA members follow a review of the latest evidence — including a range of recent trials of drug and lifestyle intervention — and update the last recommendations issued in 2015.

UNC School of Medicine's John Buse, MD, PhD, senior author of the paper and co-chair of the ADA consensus statement writing group, says there are two key changes in the updated recommendations.

"We have suggested changing the focus of why drugs are prescribed to patients. Instead of primarily focusing on lowering blood sugar, we now suggest physicians primarily focus on treatment to prevent heart attack, stroke, heart failure and kidney disease," said Buse, director of the UNC Diabetes Care Center and director of the NC Translational and Clinical Sciences (NC TraCS) Institute.

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NC State – NC TraCS Collaborative Pilot Grant Program

NC TraCS Collaborative Pilot Grant Program

As an integrated hub of the NIH Clinical and Translational Science Awards (CTSA) Program, the North Carolina Translational and Clinical Sciences (NC TraCS) Institute combines the research strengths, resources and opportunities of the University of North Carolina at Chapel Hill campus and partner institutions NC State University in Raleigh, North Carolina A&T State University in Greensboro, and RTI International in the Research Triangle Park.

Strategically designed to overcome barriers historically responsible for fragmenting and delaying research efforts, the NC TraCS Institute offers targeted, comprehensive and interdisciplinary solutions to investigators in the area of clinical and translational science.

The NC TraCS Institute seeks to help advance the work of those making direct impacts on health practices in research labs, clinical settings, homes, and communities — by serving as a centralized portal through which research personnel can gain access to valuable resources and services.

Of particular note is the NC TraCS Institute Pilot Grant Program, which "serves as a stimulus for new research initiatives aimed at obtaining sufficient preliminary data to allow new applications for extramural funding."

Each year, a number of these pilot grants specifically require at least one principal investigator (PI) from NC State and one from UNC-Chapel Hill, to be involved in the project.

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UNC and NC State collaborate to develop mobile health app for patients with Type 1 diabetes

Development and optimization of HEDRA, a novel m-health decision support tool for weight and glycemic control in Type 1 Diabetes

Michael R. Kosorok, PhD

Michael Kosorok, Eric Laber, Beth Mayer-Davis and Dr. Laura Young, who specializes in the care of patients with diabetes, were recently awarded funding for this project, which aims to develop a mobile health app for patients with Type 1 diabetes.

The app will help these patients "more easily engage in physical activity" by using data it collects about them to "provide personalized strategies before, during and after planned physical activity, to keep blood sugar levels in a normal range," said Anna Kahkoska, an M.D./Ph.D candidate at UNC-Chapel Hill, co-mentored by Mayer-Davis and Kosorok, whose dissertation focuses on the use of machine learning techniques to identify Type 1 diabetes patients with distinct disease subtypes who might respond better to alternative treatment options.

Laber, an associate professor in NC State's Statistics Department, explained that the statistical expertise will play a heavy role in determining how and when to implement these strategies, such as sending a reminder to take one's insulin, so as to optimize the app's effectiveness.

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Multi-institutional Workshop Identifies the "Known Unknowns" of Opioid Crisis

In a quote that has been repeated so often that it has almost become cliché, Secretary of State Donald Rumsfeld once answered a question about weapons of mass destruction by saying, "There are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns – the ones we don't know we don't know."

workshop graphic

The concepts of known knowns, known unknowns, and unknown unknowns apply not only to intelligence and politics, but to any discipline where the gathering of knowledge is paramount. So it was fitting that a workshop on the devastating opioid crisis began by invoking this quote from Rumsfeld.

The all-day event, called "Developing a Research Agenda for Addressing the Opioid Epidemic in NC," was held on May 16, 2018 at the Research Triangle Park (RTP) Conference Center in Durham. To kick off the discussion, Aaron McKethan, PhD, Chief Data Officer at the N.C. Department of Health and Human Services (NC DHHS), explained that the meeting was unconventional, by design.

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Michelle Maclay, Communications Director