The aim of this study is to assess the efficacy and safety of lixisenatide for treating type 2 diabetes. A systematic search in electronic databases (up to October 2012) was conducted and the manufacturer was contacted regarding unpublished data. Randomized controlled trials (RCTs) were included if they provided information on at least one of the following outcomes: mortality, health-related quality of life, hypoglycaemic events, adverse events, change in HbA1c, body weight, blood pressure, gastric emptying, fasting plasma glucose or 2 h postprandial glucose (PPG). Twenty-six publications and 10 unpublished study reports, relating to 14 RCTs (6156 patients) were included. Eleven studies related to placebo comparisons; active comparators were in three studies. Compared to placebo, lixisenatide significantly reduced HbA1c (-0.52%; 95% CI: -0.64 to -0.39), bodyweight (-0.65 kg; 95% CI: -0.94 to -0.37) and 2-h PPG level (-4.58 mmol/l; 95% CI: -5.88 to -3.28). There were significantly more symptomatic hypoglycaemic events among lixisenatide compared to placebo-treated patients (log OR: 0.54; 95% CI: 0.32-0.75), but significantly fewer compared to other incretin mimetics. In comparison to exenatide and liraglutide, lixisenatide was more effective in reducing 2 h-PPG with a better adverse events profile, but it showed a lower reduction in HbA1c and body weight. Lixisenatide improves HbA1c levels and moderately reduces body weight compared to placebo and showed less frequent symptomatic hypoglycaemic and gastrointestinal events and an improvement in PPG control compared to other GLP-1 agonists. Firm conclusions regarding the performance of lixisenatide compared to other incretin mimetics, however, can not yet be drawn, due to limited data.

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Background Many older people wish to remain in their own environment for as long as possible; an aim shared by the wider community. Here the results of the RegionAAL study (Steiermark, Austria) are reported. Methods An RCT was implemented to evaluate a programme of interventions (e.g. medication, drink and physical activity reminders, automatic light systems, watches to detect falls, video telephone with carers). Data was collected via quantitative questionnaires at baseline, 6 months and 1 year regarding quality of life and carers’ burden. Results 111 persons and 104 carers took part in the intervention group; 110 participants and 100 carers in the control group. Participant characteristics were similar at baseline. Average age was 76 years. Around 1/3 were formal carers. A tendency for more persons in the control group to require assistance after one year could be observed. The subscales autonomy and participation of the WHOQOL-OLD showed some significant declines in the control group (no deterioration in the intervention group). No differences between study arms regarding general health, chronic conditions or hospital admissions were observed. Expected reduction in worry among carers could not be observed, although there was a tendency for some aspects of burden to be reduced. The interventions did not lead to a reduction in carers’ workload; neither did the carers see any direct improvement of their situation. Conclusions Some technologies such as cognitive games on the tablet, portable door bell and automatic light sensor were positively assessed. The participants in the intervention group scored better on autonomy and participation subscales than the control group; the intervention group also fared somewhat better regarding independence. The technologies had little influence on general health states or quality of life of participants or carers. Further good quality studies are needed before AAL technologies are considered as a public health initiative. Key messages AAL may reduce aspects of worry among carers and prevent age-related decline in autonomy, participation and independence among older persons but not have an effect on general health status or burden. AAL has only a very limited impact upon general health status or quality of life of older persons and the general burden experienced by carers.

A 3 4 7 -A 7 6 6 on the comparison between expenditures of the diabetic and non-diabetic populations. Then, we observe over 8 years the dynamics of the costs attributable to diabetes. Results: We identify 220,000 persons who were newly treated for type 2 diabetes in 2008 (45 years and older). This provides an incidence rate of 1,160 per 100,000 insured persons. Among people with newly treated diabetes, 52% are men. The mean age is 64 years (62 years for men and 65 years for women). Based on this cohort, we aim to assess the change over time of overall cost and costs attributable to diabetes due to the natural history of the disease. ConClusions: Describing the impact of the natural history of the disease on the cost of type 2 diabetes on such a large cohort of patients will give policy maker a better understanding of how diabetes, its complications and health care affect expenditures over time.