The laboratory of Itamar Raz

• Curalin supplement for patients with type 2 diabetes mellitus.
  Diabetes/metabolism research and reviews [2023] Abstract
  Roni Weinberg Sibony, Julio Wainstein, Maya Ish Shalom, Tali Ganz, Aliza Rozenberg, Ilan Yanuv, Uri Eliyahu, Itamar Raz

Curalin supplement for patients with type 2 diabetes mellitus.

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To examine the efficacy and safety of Curalin supplement in patients with type 2 diabetes.
• [COMPARISON OF A RECOMMENDATION FOR A DESIRABLE HBA1C VALUE BY INTERNAL WARD PHYSICIANS, DIABETES PHYSICIANS AND AN APPLICATION, FOR DIABETES PATIENTS DISCHARGED FROM HOSPITALIZATION IN AN INTERNAL WARD].
  Harefuah [2022] Abstract
  Julio Wainstein, Gregory Luzovetsky, Hedi Auerbach, Itamar Raz

[COMPARISON OF A RECOMMENDATION FOR A DESIRABLE HBA1C VALUE BY INTERNAL WARD PHYSICIANS, DIABETES PHYSICIANS AND AN APPLICATION, FOR DIABETES PATIENTS DISCHARGED FROM HOSPITALIZATION IN AN INTERNAL WARD].

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In the present study we demonstrated that there are no clinically significant differences in the recommendations of the various factors that were examined as for the determination of a desirable HbA1c goal for diabetes patients who are discharged from an internal ward.
• Association of Baseline HbA1c With Cardiovascular and Renal Outcomes: Analyses From DECLARE-TIMI 58.
  Diabetes care [2022] Abstract
  Avivit Cahn, Stephen D Wiviott, Ofri Mosenzon, Erica L Goodrich, Sabina A Murphy, Ilan Yanuv, Aliza Rozenberg, Deepak L Bhatt, Lawrence A Leiter, Darren K McGuire, John P H Wilding, Ingrid A M Gause-Nilsson, Anna Maria Langkilde, Marc S Sabatine, Itamar Raz

Association of Baseline HbA1c With Cardiovascular and Renal Outcomes: Analyses From DECLARE-TIMI 58.

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Current guidelines recommend prescribing SGLT2 inhibitors to patients with type 2 diabetes and established or at high risk for atherosclerotic cardiovascular disease (ASCVD), irrespective of HbA1c levels. We studied the association of HbA1c with cardiovascular and renal outcomes and whether the benefit of dapagliflozin varies by baseline HbA1c.
• Insulin Therapy: Future Perspectives.
  American journal of therapeutics [2022] Abstract
  Simona Cernea, Itamar Raz

Insulin Therapy: Future Perspectives.

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Insufficient insulin secretion is a core pathogenetic mechanism of diabetes mellitus and therefore, insulin therapy remains the cornerstone of management. Over the past 100 years, much progress has been made in the development of insulin therapy, including elaboration of novel insulin formulations and delivery methods.
• Management of patients with diabetes and obesity in the COVID-19 era: Experiences and learnings from South and East Europe, the Middle East, and Africa.
  Diabetes research and clinical practice [2022] Abstract Free full text
  Francesco Giorgino, Sindeep Bhana, Leszek Czupryniak, Selcuk Dagdelen, Gagik R Galstyan, Andrej Jane, Nebojsa Lali, Nassim Nouri, Dario Raheli, Anca Pantea Stoian, Itamar Raz

Management of patients with diabetes and obesity in the COVID-19 era: Experiences and learnings from South and East Europe, the Middle East, and Africa.

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The COVID-19 pandemic has had a major effect on healthcare during 2020. Current evidence suggests that, while individuals with diabetes and obesity are no more prone to SARS-CoV-2 infection than those without, the risk of hospitalisation if someone has diabetes or obesity and then contracts COVID-19 is three times higher - and 4.5 times higher if they have diabetes and obesity. We assembled a panel of experts from South and East Europe, the Middle East, and Africa to discuss the challenges to management of diabetes and obesity during and post the COVID-19 pandemic. The experience and learnings of this panel cover a heterogeneous patient population, wide range of clinical settings, healthcare organisations, disease management strategies, and social factors. We discuss the importance of timely and effective disease management via telemedicine, providing reassurance and guidance for patients unable or unwilling to visit healthcare settings at this time. We address the use of novel therapies and their role in managing diabetes and obesity during the pandemic, as well as the importance of controlling hypoglycaemia and preventing cardiovascular complications, particularly in vulnerable people. Finally, we consider post-COVID-19 management of diabetes and obesity, and how these learnings and experiences should impact upon future clinical guidelines.
• Tackling obesity during the COVID-19 pandemic.
  Diabetes/metabolism research and reviews [2022] Abstract Free full text
  Amit Akirov, Avivit Cahn, Stefano Del Prato, Philip Home, Luc Van Gaal, Juliana Chan, Guang Ning, Itamar Raz

Tackling obesity during the COVID-19 pandemic.

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• NAFLD in type 2 diabetes mellitus: Still many challenging questions.
  Diabetes/metabolism research and reviews [2022] Abstract
  Simona Cernea, Itamar Raz

NAFLD in type 2 diabetes mellitus: Still many challenging questions.

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Epidemiologic data consistently show that in patients with type 2 diabetes (T2DM) the prevalence of non-alcoholic fatty liver disease (NAFLD), including advanced fibrosis, is double compared to the general population, and it associates with high risk of liver-related morbidity (advanced fibrosis, hepatocellular carcinoma) and mortality, but also with other systemic consequences, such as cardiovascular (CV) disease, chronic kidney disease, and overall mortality. There are still many answers that need to be clarified regarding NAFLD in T2DM, including deciphering the complex pathogenetic mechanisms, the intertwined relationships with the extrahepatic organs and tissues (mainly heart, kidneys, adipose tissue, gut), the prognostic value of NAFLD for CV risk stratification, and more importantly, what would be the most appropriate screening algorithm, diagnostic method and therapeutic approach. We advocate here for proactive action, in order to identify NAFLD in a timely manner, and suggest a simple algorithm to be used in clinical practice, based on risk stratification and on experts opinions. We discuss the current therapeutic options for NAFLD in T2DM, for which a multifactorial approach is needed, that concomitantly addresses the liver and the cardio-reno-metabolic disturbances.
• The relationship between inpatient hyperglycaemia and mortality is modified by baseline glycaemic status.
  Diabetes/metabolism research and reviews [2022] Abstract
  Hanaa Rayyan-Assi, Becca Feldman, Maya Leventer-Roberts, Amichay Akriv, Itamar Raz

The relationship between inpatient hyperglycaemia and mortality is modified by baseline glycaemic status.

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There is a well-established association between inpatient hyperglycaemia and mortality. However, evidence is inconsistent regarding whether this association is differential among those with and without type 2 diabetes mellitus (T2DM). Most studies are based on convenience samples or are unable to adjust for comorbidities. We examined whether the association between hyperglycaemia and 30-day mortality was modified by baseline glycaemic status.
• Management of diabetic neuropathy.
  Metabolism: clinical and experimental [2021] Abstract
  Simona Cernea, Itamar Raz

Management of diabetic neuropathy.

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Diabetic neuropathy is a neurodegenerative disorder that may alter both the somatic and autonomic peripheral nervous systems in the context of diabetes mellitus (DM). It is a prevalent and burdensome chronic complication of DM, that requires timely management. Optimized glycemic control (mainly for type 1 DM), multifactorial intervention (mainly for type 2 DM), with lifestyle intervention/physical exercise, and weight loss represent the basis of management for diabetic distal symmetrical polyneuropathy, and should be implemented early in the disease course. Despite better understanding of the pathogenetic mechanisms of diabetic peripheral neuropathy, there is still a stringent need for more pathogenetic-based agents that would significantly modify the natural history of the disease. The paper reviews the available drugs and current recommendations for the management of distal symmetrical polyneuropathy, including pain management, and for diabetic autonomic neuropathy. Evaluation of drug combinations that would perhaps be more efficient in slowing the progression of the disease or even reversing it, and that would provide a better pain management is still needed.
• Positioning sulphonylureas in a modern treatment algorithm for patients with type 2 diabetes: Expert opinion from a European consensus panel.
  Diabetes, obesity metabolism [2021] Abstract
  Agostino Consoli, Leszek Czupryniak, Rui Duarte, Gyrgy Jermendy, Alexandra Kautzky-Willer, Chantal Mathieu, Miguel Melo, Ofri Mosenzon, Frank Nobels, Nikolaos Papanas, Gabriela Roman, Oliver Schnell, Alexis Sotiropoulos, Coen D A Stehouwer, Cees J Tack, Vincent Woo, Gian Paolo Fadini, Itamar Raz

Positioning sulphonylureas in a modern treatment algorithm for patients with type 2 diabetes: Expert opinion from a European consensus panel.

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The large number of pharmacological agents available to treat type 2 diabetes (T2D) makes choosing the optimal drug for any given patient a complex task. Because newer agents offer several advantages, whether and when sulphonylureas (SUs) should still be used to treat T2D is controversial. Published treatment guidelines and recommendations should govern the general approach to diabetes management. However, expert opinions can aid in better understanding local practices and in formulating individual choices. The current consensus paper aims to provide additional guidance on the use of SUs in T2D. We summarize current local treatment guidelines in European countries, showing that SUs are still widely proposed as second-line treatment after metformin and are often ranked at the same level as newer glucose-lowering medications. Strong evidence now shows that sodium-glucose co-transporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with low hypoglycaemia risk, promote weight loss, and exert a positive impact on vascular, cardiac and renal endpoints. Thus, using SUs in place of SGLT-2is and GLP-1RAs may deprive patients of key advantages and potentially important cardiorenal benefits. In subjects with ascertained cardiovascular disease or at very high cardiovascular risk, SGLT-2is and/or GLP-1RAs should be used as part of diabetes management, in the absence of contraindications. Routine utilization of SUs as second-line agents continues to be acceptable in resource-constrained settings.