Objective: We aimed to assess the implementation of the treat-to-target (T2T) concept in rheumatoid arthritis (RA) patients in daily practice. Methods: All RA patients visiting one of the 7 academic medical centers in Israel in June 2015 with at least 3 previous clinic visits were included in this study. A common questionnaire was used to collect data from patients’ medical records, and two independent rheumatologists evaluated the collected data for the implementation of the T2T concept. The associations between T2T implementation and the categorical and continuous variables were assessed. Results: The study included 724 patients with a mean (standard deviation) age of 62.6 (13.97) years and 575 (80.4%) of them were women. Four centers used more than one scoring method, with Disease Activity Score-28 and Clinical Disease Activity Index) being most commonly used. Only 276 (38.1%) patients had disease score results in ≥3 visits, and the T2T recommendations were implemented for 245 (33.8%) of the 724 patients. The rate of implementation was higher in younger (p=0.028) rheumatoid factor-positive patients (p=0.011) and varied between centers (11.1%-87% p

Background: Research on quality of life (QoL)-related concerns among patients with both diabetes mellitus (DM) and cancer is limited. This study compared the QoL-related concerns and characteristics among chemotherapy-treated patients with cancer and DM to those without DM. Methods: Chemotherapy-treated patients were evaluated during integrative oncology (IO) consultations, which included evidence-based complementary therapies recommended by their healthcare providers to address quality of life (QoL) concerns. During these consultations, the participants were assessed for comorbidities, including diabetes mellitus (DM). QoL-related concerns were measured using the Edmonton Symptom Assessment Scale (ESAS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Of the 1171 patients referred for an IO consultation, 272 (23.2%) had an established diagnosis of DM. The DM patients were older, presented with more advanced stages of cancer, and had more chronic comorbidities (p < 0.001). While fatigue was the most frequently reported QoL-related concern in both groups, the patients with DM had more severe pain scores in the ESAS (4.9 vs. 4.4, p = 0.022) and lower ESAS well-being scores (5.9 vs. 5.5, p = 0.021). Conclusions: Chemotherapy-treated patients with cancer and DM are characterized by higher rates of comorbidities and report more severe scores for pain and for poorer general well-being. Oncologists and diabetologists should consider referring patients with both diagnoses for an IO consultation to address their QoL-related concerns. More research is needed to understand the impact of IO consultations and treatments on well-being among patients diagnosed with both DM and cancer.

Purpose of Review: We review the literature on the interconnections between diabetes and mental health disorders, such as depression and anxiety, highlighting recent findings and potential integrative medicine (IM) interventions for improving patient care in individuals with both comorbidities. Recent Findings: Underscore the bidirectional relationship between diabetes and depression, with each condition exacerbating the other with associated poorer clinical outcomes. Pathophysiological mechanisms like hypothalamic-pituitary-adrenal (HPA) axis dysregulation and chronic inflammation contribute significantly. IM approaches, including mind-body therapies, dietary modifications, and herbal medicine, show promise in enhancing both glycemic control and mental health well-being. Summary: IM offers a holistic, patient-centered approach potentially improving care for individuals with diabetes and mental health disorders. While evidence supports the efficacy of various integrative therapies, further rigorous research is needed to standardize these interventions and ensure their effective integration into conventional medical practice.

BACKGROUND Glucagon-like peptide-1 receptor agonists (GLP-1RAs) play a key role in managing type 2 diabetes mellitus (T2DM). Transitioning between different GLP-1RA has been proposed as a treatment strategy. AIM To investigate switching patterns between GLP-1RA and their impact on glycemic control. METHODS A retrospective study involving patients with T2DM who initiated GLP-1RA therapy between 2009 and 2021 and transitioned to another GLP-1RA. Baseline glycated hemoglobin (HbA1c) was defined as the most recent measurement within 1 year prior to switching, and follow-up HbA1c was the first measurement recorded 4-15 months post-switch. RESULTS Among 70654 patients initiating GLP-1RA therapy, 18047 (25.5%) switched regimens. In the 13970 patients with available HbA1c, levels decreased from 8.5% ± 1.6% to 7.6% ± 1.4% (P < 0.001). HbA1c decreased in 78.3% (10943/13970) of these patients, with the most frequent improvement observed in those switching from daily to weekly GLP-1RA (81%, 5582/6890). CONCLUSION Switching between GLP-1RAs can serve as a practical alternative to treatment intensification for effectively managing T2DM.