Saturday , November 25 2017

From the Editor

November, 2017

  • 25 November

    Nov. 25, 2017

    A few years ago I served as president of the Tampa Bay chapter of JDRF. At the same time one of my good Pharmacist-CDE friends was president of the local ADA chapter, and we would always tease each other as to who was raising the most money for our respective …

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Latest Articles

November, 2017

Test Your Knowledge

A1C Treatment Plan

A 54-year-old male presents to your office for an initial visit. His past medical history is significant for hypertension, hypertriglyceridemia and acute pancreatitis. His current lab results show an A1C 9.1%, which is confirmed on a repeat lab. You would like to start him on an antihyperglycemic treatment regimen. Which of the following two-drug combinations is contraindicated for this patient?

Correct

Correct Answer: D. Metformin + a GLP-1 receptor agonist

Educational Critique: Given this patient’s A1C, initiating a 2-drug combination therapy would be an appropriate choice. The incretin-based drugs (GLP-1 receptor agonist and DPP-4 inhibitors) are contraindicated if there is a history of pancreatitis as they have been linked to reports of acute pancreatitis, although their possible role increasing the risk of pancreatitis is not clear. The GLP-1 receptor agonists are glucose dependent and work at the pancreatic level to stimulate insulin secretion and suppress glucagon production. DPP-4 inhibitors inhibit DDP-4 (DDP-4 inactivates the incretins), leading to an increase in active incretin levels.

Incorrect

More Articles

November, 2017

  • 25 November

    CGM Future

    Do you believe that glucose monitors will be a thing of the past as continuous glucose monitors (CGM) become less expensive and more accurate? Follow the link to see how you and your colleagues compare!

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  • 25 November

    The Next CGMS is the Senseonics Eversence System

    Once given FDA approval, the Senseonics Eversence System will be the fourth CGMS available in the U.S. It was submitted to the FDA for premarket approval last October, supported by data from a 90-patient pivotal trial of the device. The trial followed adults with type 1 or type 2 diabetes over 90 days of CGM sensor wearing. This is an implantable CGM system that is currently approved in Europe. The sensor sits just under your skin and can stay there for anywhere from 90-180 days.

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  • 25 November

    Julia Greenstein Current Interview

    Julia Greenstein, Ph. D. is the JDRF Vice President of Discovery Research, which includes early-stage programs across the JDRF portfolio. Dr. Greenstein has more than 20 years of experience in the corporate biotechnology arena, holding leadership positions that have helped accelerate discoveries to market.

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  • 25 November

    Julia Greenstein Transcript

    Julia Greenstein discusses JDRF research into how beta cell stress and the immune system are contributing to the pathways of initiating and continuing the destruction of the beta cells in type 1 diabetes.

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  • 25 November

    Julia Greenstein Full Interview

    In this Exclusive Interview, Dr. Julia Greenstein talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the work at the JDRF to prevent diabetes and the encouraging results of the use of a cancer drug as a possible diabetes treatment.

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  • 21 November

    Julia Greenstein Part 1, Introduction and JDRF Future Research

    In part 1 of this Exclusive Interview, Dr. Julia Greenstein talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about research plans at the JDRF.

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  • 21 November

    Julia Greenstein Part 2, Diabetes Prevention

    In part 2 of this Exclusive Interview, Dr. Julia Greenstein talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about potential for successfully preventing diabetes.

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  • 21 November

    Julia Greenstein Part 3, Gleevec Treatment for Diabetes

    In part 3 of this Exclusive Interview, Dr. Julia Greenstein talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about a cancer drug that is showing potential in the treatment or even prevention of diabetes.

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  • 21 November

    Julia Greenstein Part 4, Final Thoughts

    In part 4, the conclusion of this Exclusive Interview, Dr. Julia Greenstein talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the name and mission of the JDRF.

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  • 21 November

    Do You “Make Room” for Your Patients?

    Female, 67 years of age, type 2 diabetes, class 2 diabetes, depression, hyperlipidemia, vitamin D deficiency plus more. Her A1C is 6.8% and her lipids are within goal. Her random glucose 2 hours after eating cookies was 118 today. Her glucose lowering meds are Trulicity, metformin, and Jardiance. She takes them as prescribed. Her endocrinologist recommended she meet with me. She refused until he recommended she see me the same day she was coming in to see another health care provider for her monthly infusion for another disease process to make getting here easier.

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  • 21 November

    Aaron Vinik Part 3, Reversing Heart Disease

    In part 3 of this Exclusive Interview, Dr. Aaron Vinik talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about the hurdle of trying to reverse arteriosclerosis.

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  • 21 November

    Diabetes 2017 Part 2

    In this week's Homerun Slides, a look at empagliflozin and the effects of SGLT-2 inhibitors.

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  • 21 November

    International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #100: Pathogenesis of nonalcoholic fatty liver disease (NAFLD) Part 2

    Cause of NAFLD: obesity and abnormalities in adipose tissue. Although both NAFLD and the MetS can occur in nonobese subjects, the prevalence of NAFLD is markedly increased in obesity as is that of the MetS. In the third National Health and Nutrition Examination Survey (NHANES), the prevalence of NAFLD averaged 7.5% and 6.7% in normal-weight men and women but was 57 and 44% in persons with a body mass index (BMI) greater than 35 kgm−2.

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  • 18 November

    New Information on SGLT-2 Inhibitors

    Research presented at the American Heart Association provided new insight into  two large diabetes drug trials, CANVAS and EMPA-REG OUTCOME.

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  • 18 November

    Next CGMS “Flash” FreeStyle Libre FDA Approved, Available Shortly

    CGM will be available at lower price, without fingerstick calibration, and can be worn for 10 days with 12-hour warmup.

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