Diabetic Digest - August 29, 2018

Readers:

I've got two very interesting stories for you today. The first is about the use of AI in detecting diabetic retinopathy. The second is about the diabetes drug liraglutide may also help to reduce heart disease risk.

Plus, I found a great recipe for a Grilled Veggie Salad that's beyond delicious!

Great stories, great recipes! Please enjoy.

Regards,
Steve

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Comments? Questions? Email Steve


*-- Diabetic News --*
AI system can detect diabetic retinopathy
Researchers have developed a system that uses artificial intelligence to successfully detect diabetic retinopathy, according to a clinical trial in primary care offices.

The trial compared the performance of IDx-DR to the gold standard diagnostic for diabetic retinopathy, which is the leading cause of vision loss in adults. The study, which was published Tuesday in the journal Nature Digital Medicine, followed authorization by the U.S. Food and Drug Administration in April.

"The AI system's primary role is to identify those people with diabetes who are likely to have diabetic retinopathy that requires further evaluation by an eye-care provider," principal investigator Dr. Michael Abràmoff said in a press release. "The study results demonstrate the safety of autonomous AI systems to bring specialty-level diagnostics to a primary care setting, with the potential to increase access and lower cost."

He is founder and president of IDx, which created the IDx-DR system and funded the study.

More than 24,000 people lose their sight to diabetic retinopathy each year in the United States from severe complications of diabetes. Diabetes affects the blood vessels in the retina, causing them to leak and distort vision.

There is no cure for diabetic retinopathy, which is the most common cause of vision impairment and blindness among working-age adults in the United States. The number of Americans with diabetic retinopathy is projected to increase from 7.7 million in 2010 to 14.6 million in 2050, according to the Centers for Disease Control and Prevention.

Researchers recruited 900 adult patients with diabetes and history of diabetic retinopathy at 10 primary care sites in the United States last year. Complete diagnostic data were available for 819 participants, with a median age of 59.

AI assisted the operator in getting good-quality retinal images using a robotic camera.

After four images were obtained, the AI system then made a clinical diagnosis in 20 seconds.

Like expert clinicians, the AI detects the lesions characteristic for diabetic retinopathy, including microaneurysms, hemorrhages and lipoprotein exudates.

"This was much more than just a study testing an algorithm on an image," Abramoff said. "We wanted to test it in the places where it will be used, by the people who will use it, and we compared it to the highest standard in the world."

Camera operators in the study were not physicians or trained photographers.

Also, participants had retinal images taken at each of the primary care clinics using specialized widefield and 3D imaging equipment without AI operated by experienced retinal photographers.

FPRC readers identified 198 participants with more than mild diabetic retinopathy and the AI correctly identified 173 of the 198 participants with disease, resulting in a sensitivity of 87 percent.

Among 621 disease-free participants identified by FPRC readers, AI identified 556 participants, for a specificity of 90 percent.

Of the 852 participants who had an FPRC diagnosis, 819 had an AI system diagnostic output for

a 96 percent imageability rate.

In June, providers at the Diabetes and Endocrinology Center at UI Health Care-Iowa River Landing in Coralville, Iowa, were the first to screen patients with the system after FDA clearance.

"We are hoping to do this also for early detection of diseases like glaucoma and macular degeneration," Abramoff said. "We are working on those algorithms already. The goal is to get these specialty diagnostics into primary care and retail, which is where the patients are."



*-- More Diabetic News --*
Study: Diabetes drug also may reduce heart disease risk
Diabetes patients who take liraglutide to treat their sugar levels might also reduce risk for heart disease, according to a study.

The drug, which is sold under the brands Victoza and Saxenda, improves heart health regardless of cholesterol levels and statin therapy, researchers report in results from the LEADER trial, which were presented Sunday at the European Society of Cardiology Annual Congress in Munich, Germany, and published in the journal Circulation.

Liraglutide, an injectable non-insulin that helps reduce blood sugar, lowered risk of death from heart attack, nonfatal heart attack and nonfatal stroke in the study. Novo Nordisk, the pharmaceutical company that developed liraglutide, funded the heart study.

"One of the many ways in which we reduce heart disease is by treating people with statins to lower their cholesterol," Dr. Subodh Verma, a cardiac surgeon-scientist and director of the CardioLink platform at St. Michael's Hospital in Canada, said in a press release. "This work brings us closer to understanding whether there is further benefit of newer agents that treat diabetes and whether those benefits persist in people who are taking statins."

Increased risks of cardiovascular disease are associated with higher levels of LDL-C.

For the trial, more than 9,300 patients with type 2 diabetes were evaluated on the effects of liraglutide on heart disease at more than 400 sites around the world. The results, Verma said, offer doctors more options for patients with the condition.

"This analysis suggests that we have another tool in our armamentarium to further reduce risk for people who have Type 2 diabetes," he said.



*-- Diabetic Recipe --*
GRILLED VEGGIE SALAD
INGREDIENTS:
1/4 cup cider vinegar
2 Tbsp. water
1/3 cup olive oil
1 envelope Italian Salad Dressing Mix
1 lb. small red potatoes, cut into quarters
1 zucchini, halved and cut into 1/2-inch chunks
1 yellow squash, halved and cut into 1/2-inch chunks
1 cup red onion, cut into slivers

DIRECTIONS:
POUR vinegar and water into cruet or medium bowl; add oil and salad dressing mix. Shake vigorously or mix until well blended. Toss with vegetables. SPOON mixture evenly onto double layer of heavy-duty aluminum foil; close foil to form tightly-sealed pouch. GRILL over medium coals or medium heat for 30 minutes, turning and shaking pouch halfway through cooking time.

Categories: Vegetables, Grill

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