News in brief: Endocrinologists make SGLTi recommendations; Don’t screen for vitamin D deficiency; Bone health concern for AEDs

Wednesday, 14 Apr 2021

SGLTi recommendations for GPs

SGLT2 inhibitors should be used more widely in people with type 2 diabetes, according to practical recommendations for GPs from endocrinologists published in the Australian Journal of Family Practice, the RACGP’s official journal.

The “impressive cardiovascular, renal and metabolic benefits, have modified the paradigm in which we approach diabetes management” according to authors led by Dr Matthew Hare  and Professor Jonathan Shaw.

“Current evidence suggests they be considered for all people with type 2 diabetes and either pre-existing cardiovascular disease or early CKD, irrespective of current HbA1c, and taking into account individual patient characteristics and potential for adverse effects,” the authors recommend.

Don’t screen people for vitamin D deficiency: USPSTF

The US Preventive Services Task Force (USPSTF) has reaffirmed its recommendation against screening for vitamin D deficiency in asymptomatic adults. In its 2021 updated Recommendation Statement the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults,” which is unchanged from its 2014 recommendation. Published in JAMA, the recommendation does not apply to people in institutional or hospital settings or pregnant women.

Epilepsy drugs may impact bone health

Children with epilepsy treated with anti-epilepsy drugs (AEDs) have a three-fold higher fracture prevalence than their healthy siblings, an Australian study has shown.

Data from 133 children with epilepsy (average age 11 years old) and 128 siblings of similar age found that there were 49 non-seizure-related fractures in children taking AEDs, compared with 21 lifetime fractures in the sibling control group, giving a 2.7 (95% CI 1.3–5.3, p = 0.007) times greater fracture prevalence. Duration of AED use and generalised tonic–clonic seizures (GTCS) were independent predictors of fractures (Odds Ratios 1.55 and 2.50, respectively).

The researchers led by Dr Sunita Kumar and Dr Peter Simm of the Department of Endocrinology and Diabetes, Royal Children’s Hospital, Melbourne, said further longitudinal prospective studies were required to further explore risk and the direct impact of epilepsy on bone health.

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