Research Roundup


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Debbie Rigby rounds up the latest in research news 

Proton pump inhibitors co‐prescribed with warfarin reduce warfarin control as measured by time in therapeutic range

Results from retrosepctive data of 4494 patients suggests taking PPIs with warfarin significantly lowers time in therapeutic range and has a higher incidence of minor bleeds. The authors conclude this combination warrants additional caution and monitoring with warfarin control as measured by TTR potentially affected.

International Journal of Clinical Practice, first published 28 June 2019.

 

Treatment of Diabetes in Older Adults

This clinical practice guideline list recommendations for the treatment of diabetes (both type 1 and type 2), in older adults. In patients aged 65 years and older with diabetes, it is recommended that outpatient diabetes regimens be designed specifically to minimize hypoglycemia. Metformin is recommended as the initial oral medication chosen for glycemic management in addition to lifestyle management. To reduce the risk of hypoglycemia, sulfonylureas should be avoided.

J Clin Endocrinol Metab 2019;104(5):1520-74.

Medscape summary

 

Impact of vitamin D on spirometry findings and quality of life in patients with chronic obstructive pulmonary disease

A randomized, double-blinded clinical trial conducted in 63 patients with COPD has shown 50,000 IU vitamin D3 supplementation is able to increase quality of life in patients with COPD. Patients took 50,000 IU vitamin D3 once a week for 8 weeks and then once a month for 4 months or placebo. There was no significant difference in lung function and number of exacerbations; however  a significant difference was observed in quality of life at 2 and 6 months.

International Journal of Chronic Obstructive Pulmonary Disease 2019;14:1495–1501.

 

Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes

A large meta-analysis of recent RCTs and systematic reviewsin nearly 1 million people has shown reduced salt intake, omega-3 LC-PUFA use, and folate supplementation could reduce risk for some cardiovascular outcomes in adults. Combined calcium plus vitamin D might increase risk for stroke. Other nutritional supplements, such as vitamin B6, vitamin A, multivitamins, antioxidants, and iron and dietary interventions, such as reduced fat intake, had no significant effect on mortality or cardiovascular disease outcomes.

Ann Intern Med. 2019.

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