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Monthly Archives: February 2018

Feb. 20, 2018

There have been a lot of diseases associated with diabetes, and it is often said that, although it is never on the death certificate, diabetes is the biggest killer. We often can think of some of the common ones, like heart failure, stroke, and kidney failure. And other conditions that …

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To Give Your Patients Hope, Listen Well to The Stories They Tell Themselves

I recently met a patient whose life is alternative medicine. Not complementary medicine but alternative medicine. A young woman in her early 30’s who was diagnosed with type 1 diabetes 10 years ago. Besides having an A1C of 10.5%, I could tell she was struggling. Her career is in alternative medicine. For years she has been looking for a way to stop taking insulin. She is looking for the cure, but as with many, has difficulty believing it’s not here yet. She has had diabetes education, but because she hasn’t really met the hcp she can relate to or who has given her the answer she wants to hear, she’s not really put things together yet.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #113: Diabetes and Sleep Apnea Part 3

OSA pathophysiology: OSA is a very complex disorder, and although obesity and fat deposition around the neck plays an important role, there are many other important players that contribute to the development of this condition. The human upper airway is a unique multipurpose structure involved in performing a variety of tasks such as speech, swallowing, and the passage of air for breathing. The airway, therefore, is composed of numerous muscles and soft tissue but lacks rigid or bony support. Most notably, it contains a collapsible portion that extends from the hard palate to the larynx, which allows the upper airway to change shape and momentarily for speech and swallowing during wakefulness; but this feature also provides the opportunity for collapse at inopportune times such as during sleep.

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Feb. 17, 2018

When I was working with endocrinologists they would often place their type one patients on metformin. I would share this with primary prescribers, and they too had good results using a type 2 drug for insulin dependent patients. We now have more choices than ever for patients and it only …

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