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This past Thursday I got to see just how good cyclists can be when they're in competition. I had qualified for the Florida Senior Games and was in Cape Coral to attempt to qualify for the nationals in the 60-64 age group. The first race was 20K and, although I averaged over 21 miles an hour, I was still over 6 minutes behind the first place finisher. In addition, across all age groups, there were many faster riders and I realized that I need more training to even keep up with the older guys.

One of my fellow riders pointed out that, even though I got smoked I was still faster than 99.9999999% of the US population across all age groups, and that just doing some physical activity could help the rest of the population immensely. This thought kind of flew in the face of the information that was in a recent Item we ran where the authors stated that, "Up to 20 percent of people with type 2 diabetes (T2D) are non-responders, that is, resistant to the beneficial effects of exercise training of all types." It turns out I was not the only one who could not agree with the authors, as our own exercise guru, Dr. Sheri Colberg provided me with a response as she answers the question, "Are There Really Exercise Non-Responders?"Read More

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Tool for your Practice

Guiding Principles for Care of People with or at Risk for Diabetes

These Guiding Principles aim to identify and synthesize areas of general agreement among existing guidelines to help guide primary care providers and health care teams to deliver quality care to adults with or at risk for diabetes. Guiding Principles for Care of People with or at Risk for Diabetes

See this week's Item #3.


Product of the Week


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Sheri Colberg, PhD - Are There Really Exercise Non-Responders?

"Are Some Individuals Programmed to Fail?" asked a recent review by Stephens and Sparks published in the Journal of Clinical Endocrinology and Metabolism in November 20141. The authors claimed thatup to 20 percent of people with type 2 diabetes (T2D) are non-responders, that is, resistant to the beneficial effects of exercise training of all types.

The main findings of that review follow: "Supervised exercise training results in substantial response variations in glucose homeostasis, insulin sensitivity, and muscle mitochondrial density, wherein approximately 15–20% of individuals fail to improve their metabolic health with exercise. Classic genetic studies have shown that the extent of the exercise training response is largely heritable, whereas new evidence demonstrates that DNA hypomethylation is linked to the exercise response in skeletal muscle. DNA sequence variation and/or epigenetic modifications may, therefore, dictate the exercise training response." The authors cited lack of overall improvements in HbA1c, muscle mitochondrial content, body fat, and body mass index in non-responders with T2D for all types of exercise training programs.... Full article


Mobile App of the Week

Glucose Buddy

GlucoseBuddy1Glucose Buddy tracks not only blood glucose as the name implies, but also A1c, medication administration, physical activity, and food intake. It integrates with other web-based services such as CalorieTrack (for more detailed diet monitoring) and The charting functionality is robust, and the app can sync its data wirelessly with other devices. Just follow this link for more information and to download the app.





Test Your Knowledge Question #759

Gastroparesis, although rarely life-threatening in patients with longstanding diabetes, has a deteriorating effect on quality of life, causes arbitrary oscillation of blood glucose, and extends the time required for absorption of food and medication.

Which of the following tests is NOT used to objectively demonstrate gastric emptying in a diabetic patient?
A. Nuclear scintigraphy
B. Wireless motility
C. Upper endoscopy
D. R-R interval study
E. Breath testing

For the complete question and answer, just follow this link. 


Diabetes In Control Has Over 15000 Studies & Articles In Our Archives

Quote of the Week!

"It is impossible to live without failing at something, unless you live so cautiously that you might has well not have lived at all, in which case you have failed by default."
                       ...J. K. Rowling


Diabetes in Control gratefully acknowledges the assistance of the following  pharmacy doctoral candidates in the preparation of this week's newsletter: 

Jennifer Piggot, LECOM University


Cast Your Vote
How many of your prediabetic patients have delayed diabetes for more than 5 years with only lifestyle changes?
CME/CE of the Week
Marc Dolce, DPM, FACFAS

Category: Wound Care
Credits: .75


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