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Monthly Archives: July 2016

Sometimes it Takes a Human

63-year-old male, moderate cognitive impairment and lives alone. Patient lost a significant amount of weight, frequent symptomatic hypoglycemia, including light-headedness and dizziness, requiring lowering and stopping some of his glucose lowering medications. GLP-1 was stopped and his glucose levels were in normal range. We were very clear that he should not resume his GLP-1 until we saw him again.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #34: Beta-Cell biology of insulin secretion Part 4 of 5

Gs-protein-coupled receptor: In pancreatic beta cells, various hormones, neurotransmitters, nucleotides, and fatty acids including GLP-1, glucose-dependent insulinotropic polypeptide (GIP), vasoactive intestinal polypeptide (VIP), pituitary adenylate cyclase-activating polypeptide (PACAP), adrenaline, ATP/ADP, lysophosphatidylcholine (LPC), and oleoylethanolamide (OEA) activate their specific receptors. These receptors when coupled with Gs-protein activate adenylate cyclase and increase cAMP production. These cAMP-increasing ligands potentiate both the 1st phase and 2nd phase of GIIS.

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July 23, 2016

For many years, we have used finger sticks as the standard for diagnosis and management of diabetes. I can remember inviting patients to come to the pharmacy for a “diabetes day” where we offered free testing, and we would often find patients with elevated glucose levels. We would also spend …

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