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Daily Archives: Feb 16, 2016

This past week, we had our 3rd endocrinologist retire since December. We have a metropolitan population of just under 3 million people, and now we are down to 17 endocrinologists — and 6 of them only take care of children. Eleven endos for 3 million people is just hard to believe. If …

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Diabetes Information Best Shared By Patients and HCPs Alike

Woman, 58 years of age, history of PCOS, prediabetes, strong family history of type 2 diabetes, cardiovascular disease and obesity. This patient lives a healthy lifestyle, including a lower carb meal plan, is very active, and keeps her weight down. Those interventions did not lower her A1C, so she educated herself and asked her NP/CDE if she should start metformin. This was about 20 years ago. Since starting metformin, A1C is in the 5.1-5.5% range. Patient regularly checks glucose, which was recently rising. A1C rose to prediabetes range again. Started on GLP-1 by NP/CDE. Patient then went to a new PCP who told her she should not be taking metformin or the GLP-1 because she does not have diabetes. Wanted to refer her to an endocrinologist....

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #11: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 5 of 5

In industrialized countries, 20–40% of T1DM patients younger than 20 years present with diabetic ketoacidosis. After adjusting for age, gender, ethnicity, diabetes type, and family history of diabetes, diabetic ketoacidosis at diagnosis was associated with lower family income, less desirable health insurance coverage, and lower parental education. Younger children present with more severe symptoms at diagnosis, because children younger than 7 years old have lost on average 80% of the islets, compared to 60% in those 7–14 years old and 40% in those older than 14 years.

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