5 New Findings on Diabetes for Pharmacy Techs to Know

Because diabetes is among the most common conditions for which pharmacies will dispense medications, a number of pharmacy technicians seek to better understand the disease.

Techs looking to stay updated on the latest diabetes research should read about the following studies.

1. Lower Blood Pressure Benefits Diabetes Patients

Although there have been many attempts to identify an optimal blood pressure level for patients with diabetes, a recent study has indicated that a target of <130 mm Hg can lower diabetics’ risk for a number of comorbid conditions.

The study, which was published in JAMA, conducted a systematic review and meta-analysis of 40 randomized, controlled, blood pressure-lowering trials that enrolled a total of 100,354 patients with diabetes.

After examining the relationship between blood pressure-lowering treatment and vascular disease, the researchers determined that lowering systolic blood pressure by 10-mm Hg was associated with lower relative risks for mortality, cardiovascular disease events, coronary heart disease events, and heart failure among diabetics with mean baseline systolic blood pressures ≥140 mm Hg.

The treatment of high blood pressure was also associated with lower risks of stroke and albuminuria, regardless of the patient’s initial systolic blood pressure.

The study authors concluded that their findings “support the use of medications for [blood pressure] lowering in these patients.”

2. Diabetes Risk Elevated by Sleep Schedule Disruption

Individuals who experience notable changes in their sleep schedules may be putting themselves at greater risk for developing diabetes.

Researchers from the University of Pittsburgh tracked the sleep schedules of 450 healthy adults aged 30 to 54 years who worked part- or full-time day shifts at least 25 hours per week. Nearly 85% of the study participants had a later halfway point in their sleep cycle on their free days compared with their workdays, while the remaining 15% had an earlier halfway point on free days compared with workdays.

After adjusting for factors such as varying sleep measures, physical activity, and caloric intake, the research team determined that the participants with a greater level of disjointedness between their sleep schedules on free versus working days tended to have poorer cholesterol profiles, higher fasting insulin levels, larger waist circumference, and higher body mass index, and they were more likely to be resistant to insulin.

“Our results, along with other recent reports, suggest that a misalignment of the biological and socially influenced sleep timing is an additional factor contributing to risk for developing obesity, type 2 diabetes, and atherosclerotic cardiovascular disease and highlight the potential for sleep and circadian-focused interventions in preventative health care,” the study authors concluded.

Their results were published in the Journal of Clinical Endocrinology & Metabolism.

3. Diabetes Potentially Predicted by Antibiotic Use

Patients’ use of antibiotics may provide a glimpse into their diabetes risk, as those who develop type 2 diabetes (T2D) have been found to take more antibiotics in the years leading up to their diagnosis than those without the disease.

A recent study published in the Journal of Clinical Endocrinology & Metabolism analyzed the antibiotic prescriptions of 170,504 patients with T2D and 1.3 million individuals without the condition. Among the study participants, those with diabetes filled an average of 0.8 antibiotic prescriptions per year, while those in the control group only filled 0.5 antibiotic prescriptions annually.

The researchers also determined that there was a particularly strong association between a diabetes diagnosis and the use of narrow-spectrum antibiotics such as penicillin. One possible explanation offered by the study authors was that gut bacteria forming as a result of antibiotic use may lead to an impaired ability to metabolize sugar, potentially contributing to diabetes.

“Further investigation into the long-term effect of antibiotic use on sugar metabolism and gut bacteria composition could reveal valuable answers about how to address this public health crisis,” said study author Kristian Hallundbæk Mikkelsen, MD, in a press release. “Patterns in antibiotic use may offer an opportunity to prevent the development of the disease or to diagnose it early.”

4. Diabetes Better Controlled with Surgery Than Medication

Obese patients with T2D may benefit more from metabolic or bariatric surgery than they would from standard medical treatments aimed at controlling their disease.

A recent study that was the first to examine the long-term outcomes of surgery on patients with T2D observed 60 diabetics aged 30 to 60 years with a body mass index ≥35 kg/m² who received gastric bypass surgery, biliopancreatic diversion surgery, or conventional medical treatment. After a 5-year follow-up period, 19 of the 38 surgical patients who completed the study had achieved and maintained diabetes remission; comparatively, none of the medically treated participants had done so.

Additionally, the patients in the surgery group experienced lower blood glucose levels, used fewer diabetes and cardiovascular medications, and reported better quality-of-life (QOL) scores than those who were medically treated.

Between the 2 forms of surgery, biliopancreatic diversion resulted in greater diabetes remission rates than gastric bypass at year 5 (67% vs 37%), though gastric bypass was associated with fewer significant nutritional adverse effects and better QOL scores.

While the study authors observed few diabetes-related complications in those who received surgery, they acknowledged that the relatively small number of trial participants prevented them from drawing definitive conclusions about the ability of surgery to reduce diabetes complications.

Their results were published in Lancet.

5. Pharmacists Can Improve Outcomes for Diabetics Who Undergo Surgery

Diabetics who choose to undergo surgery experience fewer complications and readmission after their procedure when a pharmacist manages their high blood sugar.

A recent study monitored the effects of a glycemic control program in which pharmacists managed the blood sugar of non-critically ill postoperative patients with diabetes. The research team enrolled a total of 11,553 patients, 1277 of whom were in a pre-intervention phase, 4811 of whom were in the first year of the intervention, and 5465 of whom were in the second year of the invention.

The researchers found that those in the intervention group were more than twice as likely to have well-controlled blood sugar at 1 day post-surgery than those in the pre-intervention group. Participants in the intervention group were also 69% less likely to have hypoglycemia in the 3 days following surgery.

Additionally, the patients in the intervention group were nearly one-third less likely to either visit the emergency room or be readmitted to the hospital during the 3 months after discharge.

“The main takeaway is that by resourcing a glycemic control pharmacist program, we can not only improve blood sugar control and reduce hypoglycemia—key safety measures in themselves&mdash;but also apparently prevent later complications that could lead to return visits to the emergency department or readmission to the hospital,” study authors Karen Mularski, MD, and David Mosen, PhD, MPH, previously told Pharmacy Times.

The study was published in the American Journal of Pharmacy Benefits.